Organization
SOUTH MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH ANN WILES (OFFICE MANAGER)
(931) 422-5029
Entity
Organization
Contact information
Practice address
118 2ND AVE SOUTH, LEWISBURG, TN 37091
(931) 422-5029
(931) 422-5229
Mailing address
118 2ND AVE SOUTH, LEWISBURG, TN 37091
(931) 422-5029
(931) 422-5229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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