Provider Demographics
NPI:1659602274
Name:CENTRAL TENNESSEE INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:CENTRAL TENNESSEE INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CETIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEKIMOGLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-728-9744
Mailing Address - Street 1:1321 MCARTHUR ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2492
Mailing Address - Country:US
Mailing Address - Phone:931-728-9744
Mailing Address - Fax:931-728-9746
Practice Address - Street 1:1321 MCARTHUR ST
Practice Address - Street 2:SUITE B
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2492
Practice Address - Country:US
Practice Address - Phone:931-728-9744
Practice Address - Fax:931-728-9746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007522207Q00000X
TNMD41556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty