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Organization
MEDWEST FAMILY PRACTICE, INC.
Active
Organization
MEDWEST FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GARDINER (ADMINISTRATOR)
(615) 792-2292
Entity
Organization
Contact information
Practice address
104 FREY ST, SUITE 100, ASHLAND CITY, TN 37015-1792
(615) 792-2292
(615) 792-2207
Mailing address
PO BOX 24010, NASHVILLE, TN 37202-4010
(615) 792-2292
(615) 376-0199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
02/05/2007
Last updated
03/04/2008
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