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Organization
AMG CROCKETT LLC
Active
Organization
AMG CROCKETT LLC
Active
Other names
Southern Tennessee Pulmonology
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY J. WILLIS (MARKET MANAGER)
(931) 766-3344
Entity
Organization
Contact information
Practice address
1323 S LOCUST AVE, LAWRENCEBURG, TN 38464-4040
(931) 766-0850
(931) 766-0849
Mailing address
1323 S LOCUST AVE, LAWRENCEBURG, TN 38464-4040
(931) 766-0850
(931) 766-0849
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
NULL
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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