# NORTHSIDE MEDICAL PROFESSIONALS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northside Medical Professionals Pulaski
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588420814
- **Authorized official:** CARRIE LYNN STEWART (BILLING SUPERVISOR)
- **Authorized official phone:** (931) 797-0425

## Contact information

- **Practice address:** 1414 W COLLEGE ST, PULASKI, TN 38478-5202
- **Practice address phone:** (931) 540-4210
- **Practice address fax:** (931) 380-1202
- **Mailing address:** 1605 NASHVILLE HWY STE 200, COLUMBIA, TN 38401-2132
- **Mailing address phone:** (931) 540-4210
- **Mailing address fax:** (931) 380-1202

## Taxonomy

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

## Other

- **Enumeration date:** 02/23/2024
- **Last updated:** 02/23/2024