# MAURY REGIONAL MEDICAL GROUP, INC

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

## Provider details

- **NPI number:** 1962055947
- **Authorized official:** PAMELA L DAWSON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (931) 490-7019

## Contact information

- **Practice address:** 1218 TROTWOOD AVE, COLUMBIA, TN 38401-6406
- **Practice address phone:** (931) 380-4114
- **Practice address fax:** (931) 380-4106
- **Mailing address:** 854 W JAMES M CAMPBELL BLVD STE 303, COLUMBIA, TN 38401-4672
- **Mailing address phone:** (931) 540-4255
- **Mailing address fax:** (931) 490-4654

## Taxonomy

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

## Other

- **Enumeration date:** 07/19/2019
- **Last updated:** 07/19/2019