Organization
WHITE BLUFF FAMILY HEALTH CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN SIMON FNP (OWNER)
(615) 797-3646
Entity
Organization
Contact information
Practice address
2004 HIGHWAY 47 NORTH, WHITE BLUFF, TN 37187
(615) 797-3646
(615) 797-4055
Mailing address
PO BOX 624, GOODLETTSVILLE, TN 37070-0624
(615) 797-3646
(615) 797-4055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
93835
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3711042
—
TN
Enumeration date
09/15/2006
Last updated
02/14/2008
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