Organization
STATE OF TENNESSEE
Active
Other names
West Tennessee Regional Health Office Communiable Disease Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN BARNES (REGIONAL DIRECTOR)
(731) 421-6700
Entity
Organization
Contact information
Practice address
295 SUMMAR AVE, JACKSON, TN 38301
(731) 421-6730
(731) 421-5000
Mailing address
295 SUMMAR AVE, JACKSON, TN 38301
(731) 421-6730
(731) 421-5000
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007379
—
TN
Enumeration date
01/11/2007
Last updated
09/01/2010
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