Provider Demographics
NPI:1215363486
Name:MEDICAL ADVANTAGE PLLC
Entity Type:Organization
Organization Name:MEDICAL ADVANTAGE PLLC
Other - Org Name:BROWNSVILLE'S MEDICAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-234-5785
Mailing Address - Street 1:20 N WASHINGTON AVE
Mailing Address - Street 2:PO BOX 89
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-2555
Mailing Address - Country:US
Mailing Address - Phone:731-741-4030
Mailing Address - Fax:731-741-4080
Practice Address - Street 1:20 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-2555
Practice Address - Country:US
Practice Address - Phone:731-741-4030
Practice Address - Fax:731-741-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty