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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
811 MORROW ST STE 207, DRESDEN, TN 38225-1847
(731) 364-4900
(833) 690-3848
Mailing address
205A HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ODT1599
TN
207Q00000X
Family Medicine Physician
MD23833
TN
261Q00000X
Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363A00000X
Physician Assistant
PA1262
TN
363LF0000X
Family Nurse Practitioner
APN14751
TN
Other
Enumeration date
10/09/2009
Last updated
05/06/2024
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