VIVIAN FAMILY MEDICAL LLC NPI 1568457851

NPI Information

VIVIAN FAMILY MEDICAL LLC is a medical physician assistant in Cookeville, TN. VIVIAN FAMILY MEDICAL LLC NPI is 1568457851. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Cookeville Family Medicine & Urgent Care.

The provider's business location address is:

675 S JEFFERSON AVE
COOKEVILLE, TN
ZIP 38501-949
Phone: (931) 520-0148
Fax: (931) 520-0152

The provider's authorized official is Freedom Dawn Vivian .
The authorized official title is Owner and has the following contact phone number (931) 520-0148.

The CLIA number assigned to this NPI record is 44D1062003 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/13/2005 and was last updated on 5/9/2012.

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:

Other Identifiers

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