Provider Demographics
NPI:1982938122
Name:CIRCUIT ATHLETICS LLC
Entity Type:Organization
Organization Name:CIRCUIT ATHLETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:931-552-2804
Mailing Address - Street 1:1865B ASHLAND CITY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6447
Mailing Address - Country:US
Mailing Address - Phone:931-552-2804
Mailing Address - Fax:931-552-2861
Practice Address - Street 1:1865B ASHLAND CITY RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6447
Practice Address - Country:US
Practice Address - Phone:931-552-2804
Practice Address - Fax:931-552-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty