Organization
PROVIDENCE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATINA E HUFF PAC (OWNER)
(931) 836-3262
Entity
Organization
Contact information
Practice address
287 W TURN TABLE RD, SPARTA, TN 38583-1366
(931) 836-3262
(931) 836-3269
Mailing address
287 W TURN TABLE RD, SPARTA, TN 38583-1366
(931) 836-3262
(931) 836-3269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529553
—
TN
Enumeration date
07/25/2019
Last updated
11/03/2020
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