# FAMILY PRACTICE OF COVINGTON, INC

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

## Provider details

- **NPI number:** 1770781544
- **Authorized official:** MS. SOPHIA MICHELLE JOHNSON (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (901) 475-4752

## Contact information

- **Practice address:** 4235 HIGHWAY 51 SOUTH, BRIGHTON, TN 38011-6921
- **Practice address phone:** (901) 475-4752
- **Practice address fax:** (901) 475-1554
- **Mailing address:** P.O. BOX 507, COVINGTON, TN 38019-0507
- **Mailing address phone:** (901) 475-4752
- **Mailing address fax:** (901) 475-1554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD11374 | TN | Yes |

## Other

- **Enumeration date:** 07/03/2007
- **Last updated:** 08/18/2009