Organization
MCKENZIE MEDICAL CENTER, PC
Active
Other names
Hometown Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY ETHERIDGE (CHIEF OPERATING OFFICER)
(731) 352-7907
Entity
Organization
Contact information
Practice address
105 N CEDAR ST, GLEASON, TN 38229-7264
(731) 648-5634
(833) 690-3848
Mailing address
205A HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-7907
(833) 690-3848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ODT1599
TN
207Q00000X
Family Medicine Physician
MD23833
TN
207R00000X
Internal Medicine Physician
APN15541
TN
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
APN15541
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3380640
GROUP MEDICAID
TN
05
—
3730458
—
TN
Enumeration date
05/23/2006
Last updated
05/06/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us