Provider Demographics
NPI:1780675066
Name:WEST TENNESSEE REHAB GROUP, P.C.
Entity Type:Organization
Organization Name:WEST TENNESSEE REHAB GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:CURWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-664-7744
Mailing Address - Street 1:60 LYNOAK COVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2800
Mailing Address - Country:US
Mailing Address - Phone:731-664-7744
Mailing Address - Fax:731-660-2813
Practice Address - Street 1:60 LYNOAK COVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2800
Practice Address - Country:US
Practice Address - Phone:731-664-7744
Practice Address - Fax:731-660-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3071634OtherBC/BS TN
TN3711538OtherTN MEDICAID
TN4109626OtherTENNCARE SELECT
TNCE7611OtherRR MEDICARE
TN4109626OtherTENNCARE SELECT
TN4109626OtherTENNCARE SELECT