Provider Demographics
NPI:1790989259
Name:COMPLETE CARE, P.C.
Entity Type:Organization
Organization Name:COMPLETE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:NUGENT
Authorized Official - Last Name:KERSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:731-926-1502
Mailing Address - Street 1:1960 PICKWICK ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-5309
Mailing Address - Country:US
Mailing Address - Phone:731-926-1502
Mailing Address - Fax:731-926-4062
Practice Address - Street 1:195 ENOCH BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-2240
Practice Address - Country:US
Practice Address - Phone:731-926-1502
Practice Address - Fax:731-926-4062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3722987Medicaid
TN3722987Medicaid
TN3722987Medicare ID - Type UnspecifiedGROUP MEDICARE #