Organization
SDG PRIMARY AND IMMEDIATE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S HAMPTON FNP (PRESIDENT)
(731) 676-1840
Entity
Organization
Contact information
Practice address
201 S FRONT ST, HALLS, TN 38040-1547
(731) 836-5617
Mailing address
201 S FRONT ST, HALLS, TN 38040-1547
(731) 836-5617
(731) 836-5284
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q007486
—
TN
Enumeration date
08/21/2014
Last updated
01/31/2024
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