COVENANT MEDICAL GROUP INC NPI 1629266994

NPI Information

NPI: 1629266994
Provider Name: COVENANT MEDICAL GROUP INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 44D1076763

Address:
415 HENSLEE DR
DICKSON, TN
ZIP 37055
Phone: (615) 441-6140
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COVENANT MEDICAL GROUP INC is a primary care clinic center in Dickson, TN. COVENANT MEDICAL GROUP INC NPI is 1629266994. The provider is registered as an organization entity type.

The provider's business location address is:

415 HENSLEE DR
DICKSON, TN
ZIP 37055-166
Phone: (615) 441-6140
Fax: (615) 441-6190

The provider's authorized official is Walter Stephens .
The authorized official title is Owner and has the following contact phone number (615) 441-6140.

The CLIA number assigned to this NPI record is 44D1076763 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2007 and was last updated on 1/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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