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Organization
THE RUTHERFORD MEDICAL CLINIC LLC
Active
Organization
THE RUTHERFORD MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL E LITTLE FNP (PROVIDER/OWNER)
(731) 665-7741
Entity
Organization
Contact information
Practice address
104 E MAIN ST, RUTHERFORD, TN 38369-9711
(731) 665-7741
(731) 665-7750
Mailing address
PO BOX 370, RUTHERFORD, TN 38369-0370
(731) 665-7741
(731) 665-7750
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5442152
—
TN
Enumeration date
02/20/2008
Last updated
08/05/2019
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