Organization
AMG CROCKETT LLC
Active
Other names
SOUTHERN TENNESSEE HEART
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY J. WILLIS (MARKET MANAGER)
(931) 766-4574
Entity
Organization
Contact information
Practice address
1611 S LOCUST AVE, SUITE 200B, LAWRENCEBURG, TN 38464-4055
(931) 766-3684
Mailing address
1611 S LOCUST AVE, SUITE 200B, LAWRENCEBURG, TN 38464-4055
(931) 766-3684
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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