# AMEN CLINIC PC

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

## Provider details

- **NPI number:** 1407121551
- **Authorized official:** EZEKIEL O ADETUNJI MD (OWNER)
- **Authorized official phone:** (731) 300-3168

## Contact information

- **Practice address:** 150 MURRAY GUARD DR, JACKSON, TN 38305
- **Practice address phone:** (731) 300-3168
- **Practice address fax:** (731) 300-3169
- **Mailing address:** PO BOX 12485, JACKSON, TN 38308-0143
- **Mailing address phone:** (731) 300-3168
- **Mailing address fax:** (731) 300-3169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2012
- **Last updated:** 06/27/2018