Organization
G.B. MEDICAL ASSOICATES, INC.
Active
Other names
Tullahoma Advanced Care
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY J BONNAIRE MD (OWNER)
(931) 393-2245
Entity
Organization
Contact information
Practice address
601 NW ATLANTIC ST, TULLAHOMA, TN 37388-3536
(931) 393-2245
(931) 393-2247
Mailing address
601 NW ATLANTIC ST, TULLAHOMA, TN 37388-3536
(931) 393-2245
(931) 393-2247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10071451
AMERIGROUP
TN
01
—
1326099060
NPI
TN
05
—
3733675
—
TN
01
—
4124529
BCBS
TN
Enumeration date
05/15/2006
Last updated
08/22/2020
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