# MONTEREY MEDICAL LLC

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

## Provider details

- **NPI number:** 1497339790
- **Authorized official:** CRYSTAL DENISE VAUGHN (VICE PRESIDENT)
- **Authorized official phone:** (931) 260-5756

## Contact information

- **Practice address:** 400 W CRAWFORD AVE, MONTEREY, TN 38574-1166
- **Practice address phone:** (931) 839-2224
- **Practice address fax:** (931) 839-2530
- **Mailing address:** 400 W CRAWFORD AVE, MONTEREY, TN 38574-1166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/12/2021
- **Last updated:** 07/08/2021