MCKENZIE MEDICAL CENTER PC NPI 1477516953

NPI Information

NPI: 1477516953
Provider Name: MCKENZIE MEDICAL CENTER PC

Doing Business As: HOMETOWN HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
205 HOSPITAL DR
SUITE A
MC KENZIE, TN
ZIP 38201
Phone: (731) 352-7907
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MCKENZIE MEDICAL CENTER PC is a rural health clinic center in Mc Kenzie, TN. MCKENZIE MEDICAL CENTER PC NPI is 1477516953. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Hometown Health Clinic.

The provider's business location address is:

205 HOSPITAL DR
SUITE A
MC KENZIE, TN
ZIP 38201-649
Phone: (731) 352-7907
Fax: (731) 352-4459

The provider's authorized official is Tammy Etheridge .
The authorized official title is Chief Operating Officer and has the following contact phone number (731) 352-7907.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 3/12/2024.

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	1041C0700X	Social Worker	Clinical	LSW5620	TENNESSEE	No
2	106H00000X	Marriage & Family Therapist		LMFT917	TENNESSEE	No
3	152W00000X	Optometrist		ODT441	TENNESSEE	No
4	207R00000X	Internal Medicine		MD15682	TENNESSEE	No
5	208000000X	Pediatrics		MD46412	TENNESSEE	No
6	261QR1300X	Clinic/Center	Rural Health			Yes
7	363A00000X	Physician Assistant		PA1503	TENNESSEE	No
8	363LF0000X	Nurse Practitioner	Family	APN6244	TENNESSEE	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3380640	OTHER	TENNESSEE	GROUP MEDICAID
2	3380640	OTHER	TENNESSEE	GROUP MEDICARE

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: 4/28/2024

NPI Synchronization or Removal

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