Organization
PROVIDENCE FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY G MYLES RMA (OFFICE MANAGER)
(615) 860-8182
Entity
Organization
Contact information
Practice address
1210 BRIARVILLE RD BLDG E, MADISON, TN 37115-5136
(615) 860-8182
(615) 860-8184
Mailing address
1210 BRIARVILLE RD BLDG E, MADISON, TN 37115-5136
(615) 860-8182
(615) 860-8184
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
37235
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376722546
NPI GROUP
—
Enumeration date
10/24/2007
Last updated
10/21/2008
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