# WAYNESBORO CLINIC, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1407207814
- **Authorized official:** DR. DONALD HOWARD POLK DO (MEMBER/PHYSICIAN)
- **Authorized official phone:** (931) 722-3677

## Contact information

- **Practice address:** 206 CLIFTON TPKE, WAYNESBORO, TN 38485-2301
- **Practice address phone:** (931) 722-3677
- **Practice address fax:** (931) 722-4677
- **Mailing address:** PO BOX 778, WAYNESBORO, TN 38485-0778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DO127 | TN | Yes |

## Other

- **Enumeration date:** 06/27/2016
- **Last updated:** 06/27/2016