Provider Demographics
NPI:1306016779
Name:WILLIAMSON SAINT THOMAS COMMUNITY HEALTH
Entity Type:Organization
Organization Name:WILLIAMSON SAINT THOMAS COMMUNITY HEALTH
Other - Org Name:WILLIAMSON SAINT THOMAS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRUNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-384-0005
Mailing Address - Street 1:4323 CAROTHERS PKWY
Mailing Address - Street 2:SUITE #409
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5914
Mailing Address - Country:US
Mailing Address - Phone:615-435-7780
Mailing Address - Fax:615-435-7789
Practice Address - Street 1:4323 CAROTHERS PKWY
Practice Address - Street 2:SUITE #409
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5914
Practice Address - Country:US
Practice Address - Phone:615-435-7780
Practice Address - Fax:615-435-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-02
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty