Organization
CAPITAL REGIONAL HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization
Contact information
Practice address
2770 CAPITAL MEDICAL BLVD STE 200, TALLAHASSEE, FL 32308-8419
(850) 877-0910
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/06/2008
Last updated
03/23/2021
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