BOYETT HEALTHCARE OF TENNESSEE DBA IMPACT HEALTHCARE LLC NPI 1487185153

NPI Information

BOYETT HEALTHCARE OF TENNESSEE DBA IMPACT HEALTHCARE, LLC is an addiction medicine family medicine in Jackson, TN. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. BOYETT HEALTHCARE OF TENNESSEE DBA IMPACT HEALTHCARE, LLC NPI is 1487185153. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Impact Healthcare, Llc.

The provider's business location address is:

37 SANDSTONE CIR
STE 92
JACKSON, TN
ZIP 38305-089
Phone: (731) 445-4879

The provider's authorized official is Melissa Cox .
The authorized official title is Credentialing Supervisor and has the following contact phone number (205) 246-5690.

The CLIA number assigned to this NPI record is 44D2180589 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2017 and was last updated on 11/9/2021.

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:

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