Organization
FAMILY MEDICAL PC
Active
Other names
Family Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER E MCKINNEY M.D. (CO-OWNER)
(615) 444-6203
Entity
Organization
Contact information
Practice address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Mailing address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5949
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1919688
UHC
TN
05
—
3718935
—
TN
01
—
4074047
BCBS
TN
01
—
4147219
CIGNA
TN
01
—
CG9172
MEDICARE RR
TN
Enumeration date
11/09/2006
Last updated
08/10/2011
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