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Organization
FAYETTEVILLE MEDICAL ASSOCIATES, PC
Active
Organization
FAYETTEVILLE MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN HUDSON (ADMINISTRATOR)
(931) 438-1676
Entity
Organization
Contact information
Practice address
207 ELK AVE S, FAYETTEVILLE, TN 37334-3051
(931) 433-2551
(931) 438-0069
Mailing address
207 ELK AVE S, FAYETTEVILLE, TN 37334-3051
(931) 433-2551
(931) 438-0069
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
03/08/2006
Last updated
11/11/2009
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