Organization
COMMUNITY GOVERNING BOARD OF MATTEW WALKER COMPREHENSIVE CENTE
Active
Other names
Matthew Walker Comprehensive Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MCKISSACK (CHIEF EXECUTIVE OFFICER)
(615) 340-1292
Entity
Organization
Contact information
Practice address
904 26TH AVE N, NASHVILLE, TN 37208-3202
(615) 327-9400
(615) 327-2806
Mailing address
1035 14TH AVE N, NASHVILLE, TN 37208-3050
(615) 327-9400
(615) 327-2806
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T07209A
—
TN
Enumeration date
09/30/2008
Last updated
02/25/2022
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