Provider Demographics
NPI:1639482292
Name:CENTERS FOR FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:CENTERS FOR FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-889-6080
Mailing Address - Street 1:5114 OLD HICKORY BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2589
Mailing Address - Country:US
Mailing Address - Phone:615-889-6080
Mailing Address - Fax:615-884-0370
Practice Address - Street 1:5114 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2589
Practice Address - Country:US
Practice Address - Phone:615-889-6080
Practice Address - Fax:615-884-0370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNBM7363447207R00000X
TNDPM230213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty