# TROUSDALE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1669765442
- **Authorized official:** WILLIAM D LYLES JR. MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (615) 374-0703

## Contact information

- **Practice address:** 205 BROADWAY, HARTSVILLE, TN 37074-1303
- **Practice address phone:** (615) 374-0703
- **Practice address fax:** (615) 374-0019
- **Mailing address:** 205 BROADWAY, P.O. BOX 483, HARTSVILLE, TN 37074-1303
- **Mailing address phone:** (615) 374-0703
- **Mailing address fax:** (615) 374-0019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 16864 | TN | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | 16864 | TN | — |

## Other

- **Enumeration date:** 05/26/2011
- **Last updated:** 05/26/2011