# AMG CROCKETT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** First Choice Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659514776
- **Authorized official:** MR. MICHAEL B CLARK (PRESIDENT)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 106 S MILITARY AVE, LORETTO, TN 38469-2101
- **Practice address phone:** (931) 853-4622
- **Practice address fax:** (931) 853-4621
- **Mailing address:** 106 S MILITARY AVE, LORETTO, TN 38469-2101
- **Mailing address phone:** (931) 853-4622
- **Mailing address fax:** (931) 853-4621

## Taxonomy

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

## Other

- **Enumeration date:** 04/20/2009
- **Last updated:** 04/20/2009