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TENN-TOM MED LLC NPI 1174294797


NPI Information

NPI: 1174294797
Provider Name: TENN-TOM MED LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 25D2230129

Address:
369 HIGHWAY 72
BURNSVILLE, MS
ZIP 38833
Phone: (662) 427-4040
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TENN-TOM MED LLC is a primary care clinic center in Burnsville, MS. TENN-TOM MED LLC NPI is 1174294797. The provider is registered as an organization entity type.

The provider's business location address is:

369 HIGHWAY 72
BURNSVILLE, MS
ZIP 38833-320
Phone: (662) 427-4040
Fax: (662) 427-4041

The provider's authorized official is Camille Whitehead .
The authorized official title is Managing Nurse Practitioner and has the following contact phone number (662) 427-4040.

The CLIA number assigned to this NPI record is 25D2230129 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2021 and was last updated on 4/21/2022.


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
1261QP2300XClinic/CenterPrimary CareYes

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

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