MARVEL CLINIC P.C. NPI 1760487086

NPI Information

  • NPI: 1760487086
  • Provider Name: MARVEL CLINIC P.C.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 44D0309776
  • Address: 1821 N WASHINGTON ST
    TULLAHOMA, TN
    ZIP 37388
  • Phone: (931) 455-2005

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NPI Details

MARVEL CLINIC P.C. is a specialist in Tullahoma, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MARVEL CLINIC P.C. NPI is 1760487086. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1821 N WASHINGTON ST
TULLAHOMA, TN
ZIP 37388-221
Phone: (931) 455-2005
Fax: (931) 455-4450

The provider's authorized official is Tracy Dawn Wilkins .
The authorized official title is Credentialing Facilitator and has the following contact phone number (931) 461-5056.

The CLIA number assigned to this NPI record is 44D0309776 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2005 and was last updated on 8/22/2020.

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
1174400000XSpecialistTENNESSEEYes

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: 11/21/2025

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