Organization
ROSE FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY FREEMAN M.D. (SUPERVISING PHYSICIAN)
(615) 644-3000
Entity
Organization
Contact information
Practice address
12124 HIGHWAY 52 W STE 5, WESTMORELAND, TN 37186-3257
(615) 644-3000
(615) 644-3076
Mailing address
100B MALLARD SUNRISE DR E, WESTMORELAND, TN 37186-3251
(615) 644-3000
(615) 644-3076
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
TN
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02074286
AMERIGROUP
TN
05
—
3374094
—
TN
01
—
6000322
BCBS
TN
Enumeration date
02/25/2007
Last updated
08/08/2022
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