# AMG CROCKETT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** YOUR FAMILY CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730511858
- **Authorized official:** DANIEL SYKES (VICE PRESIDENT)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 550 HIGHWAY 64 E, HURRICANE PLAZA SUITE 4, WAYNESBORO, TN 38485-3037
- **Practice address phone:** (931) 722-2230
- **Practice address fax:** (931) 722-2192
- **Mailing address:** 550 HIGHWAY 64 E, HURRICANE PLAZA SUITE 4, WAYNESBORO, TN 38485-3037
- **Mailing address phone:** (931) 722-2230
- **Mailing address fax:** (931) 722-2192

## Taxonomy

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

## Other

- **Enumeration date:** 07/31/2013
- **Last updated:** 07/31/2013