Provider Demographics
NPI:1467667592
Name:PUTNAM COUNTY RURAL HEALTH CLINIC
Entity Type:Organization
Organization Name:PUTNAM COUNTY RURAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-839-6695
Mailing Address - Street 1:117 W COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:TN
Mailing Address - Zip Code:38574-1107
Mailing Address - Country:US
Mailing Address - Phone:931-839-6695
Mailing Address - Fax:931-858-3850
Practice Address - Street 1:117 W COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:TN
Practice Address - Zip Code:38574-1107
Practice Address - Country:US
Practice Address - Phone:931-839-6695
Practice Address - Fax:931-858-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty