# STATE OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gibson County Health Department Humboldt Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821148081
- **Authorized official:** MRS. MARILYN BARNES (REGIONAL DIRECTOR)
- **Authorized official phone:** (731) 421-6700

## Contact information

- **Practice address:** 149 NORTH 12TH STREET, HUMBOLDT, TN 38343
- **Practice address phone:** (731) 784-5491
- **Practice address fax:** (731) 784-1726
- **Mailing address:** 149 NORTH 12TH STREET, HUMBOLDT, TN 38343
- **Mailing address phone:** (731) 784-5491
- **Mailing address fax:** (731) 784-1726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 08/25/2010