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Organization
MCKENZIE MEDICAL CENTER PC
Active
Organization
MCKENZIE MEDICAL CENTER PC
Active
Other names
Hometown Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY ETHERIDGE (CHIEF OPERATING OFFICER)
(731) 352-7907
Entity
Organization
Contact information
Practice address
30810 BROAD ST, BRUCETON, TN 38317-2028
(731) 586-4800
(833) 690-3848
Mailing address
205A HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-7907
(833) 690-3848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ODT1599
TN
207Q00000X
Family Medicine Physician
MD23833
TN
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/18/2008
Last updated
05/06/2024
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