Provider Demographics
NPI:1275878209
Name:FAMILY HEALTH CENTER OF ASHLAND CITY PLLC
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER OF ASHLAND CITY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DUFF
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-792-1199
Mailing Address - Street 1:342 FREY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1734
Mailing Address - Country:US
Mailing Address - Phone:615-792-1199
Mailing Address - Fax:615-792-9331
Practice Address - Street 1:342 FREY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015
Practice Address - Country:US
Practice Address - Phone:615-792-1199
Practice Address - Fax:615-792-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28452207Q00000X, 207Q00000X
TN55498207Q00000X
207Q00000X, 363A00000X, 363LA2200X, 363LF0000X
TN3151363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532785Medicaid
44D0914322OtherCLIA
6004323OtherBLUE CROSS BLUE SHIELD OF TN
103G702197Medicare PIN