# FAMILY MEDICAL CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205120284
- **Authorized official:** STEVEN WILFRED GARST MD (SOLE MBR)
- **Authorized official phone:** (423) 761-0085

## Contact information

- **Practice address:** 144 MEDICAL CENTER DR STE C, COPPERHILL, TN 37317-5006
- **Practice address phone:** (423) 548-1500
- **Practice address fax:** (423) 548-1604
- **Mailing address:** PO BOX 726, DUCKTOWN, TN 37326-0726
- **Mailing address phone:** (423) 761-0085
- **Mailing address fax:** (423) 496-4840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | MD21234 | TN | — |

## Other

- **Enumeration date:** 06/07/2011
- **Last updated:** 06/07/2011