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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
205A HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-7907
(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
1041C0700X
Clinical Social Worker
LSW5620
TN
106H00000X
Marriage & Family Therapist
LMFT917
TN
152W00000X
Optometrist
ODT441
TN
207R00000X
Internal Medicine Physician
MD15682
TN
208000000X
Pediatrics Physician
MD46412
TN
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363A00000X
Physician Assistant
PA1503
TN
363LF0000X
Family Nurse Practitioner
APN6244
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
04/07/2006
Last updated
12/03/2024
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