Provider Demographics
NPI:1629078670
Name:MIDDLE TENNESSEE FAMILY MEDICINE
Entity Type:Organization
Organization Name:MIDDLE TENNESSEE FAMILY MEDICINE
Other - Org Name:WARREN O. LANGWORTHY, MD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:O
Authorized Official - Last Name:LANGWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:615-848-2900
Mailing Address - Street 1:PO BOX 440163
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0163
Mailing Address - Country:US
Mailing Address - Phone:615-848-2900
Mailing Address - Fax:615-848-2956
Practice Address - Street 1:237 W NORTHFIELD BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0531
Practice Address - Country:US
Practice Address - Phone:615-848-2900
Practice Address - Fax:615-848-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3727524Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
TN080161173Medicare PIN