Provider Demographics
NPI:1689132193
Name:DYERSBURG FAMILY WALK-IN CLINIC
Entity Type:Organization
Organization Name:DYERSBURG FAMILY WALK-IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-285-6110
Mailing Address - Street 1:193 JIM ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4965
Mailing Address - Country:US
Mailing Address - Phone:731-924-9992
Mailing Address - Fax:731-924-9501
Practice Address - Street 1:193 JIM ADAMS DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4965
Practice Address - Country:US
Practice Address - Phone:731-924-9992
Practice Address - Fax:731-924-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty