MADISON FAM WALK IN CLINIC LIMITED NPI 1972645802

NPI Information

NPI: 1972645802
Provider Name: MADISON FAM WALK IN CLINIC LIMITED
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1660 S HIGHLAND AVE STE J
JACKSON, TN
ZIP 38301
Phone: (731) 423-8600
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MADISON FAM WALK IN CLINIC LIMITED is a family nurse practitioner in Jackson, TN. MADISON FAM WALK IN CLINIC LIMITED NPI is 1972645802. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1660 S HIGHLAND AVE STE J
JACKSON, TN
ZIP 38301-797
Phone: (731) 423-8600
Fax: (731) 423-8636

The provider's authorized official is John Fulton Weeks .
The authorized official title is Ceo and has the following contact phone number (731) 423-8600.

The enumeration date for this NPI number is 2/14/2007 and was last updated on 1/8/2010.

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	363LF0000X	Nurse Practitioner	Family			Yes

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	3724655	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE
2	3724655	MEDICAID	TENNESSEE

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: 11/14/2023

NPI Synchronization or Removal

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