Organization
TULLAHOMA INTERNAL MEDICINE, PLLC
Active
Organization
TULLAHOMA INTERNAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIMDA GUPTA M.D. (CHIEF MANAGER, OWNER)
(931) 393-3366
Entity
Organization
Contact information
Practice address
1330 CEDAR LN, SUITE 100, TULLAHOMA, TN 37388-2283
(931) 393-3366
(931) 393-1065
Mailing address
PO BOX 1896, TULLAHOMA, TN 37388-1896
(931) 393-3366
(931) 393-1065
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD0000027908
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679566772
IND NPI NUMBER
TN
05
—
3810510
—
TN
01
—
MD27908
LICENSE NUMBER
TN
Enumeration date
03/28/2007
Last updated
08/22/2020
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