Organization
INTERNAL MEDICINE CLINIC OF JACKSON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HUDSON DUNNEBACKE M.D, (PLLC MEMBER)
(731) 668-9031
Entity
Organization
Contact information
Practice address
587 SKYLINE DR, JACKSON, TN 38301-3938
(731) 424-8922
(731) 423-2922
Mailing address
3 WINDWOOD DR, JACKSON, TN 38305-8835
(731) 668-9031
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD011299
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3182200
—
TN
Enumeration date
09/23/2008
Last updated
09/25/2008
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