Organization
ADVANCED FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM V CAICEDO FNP (NP)
(731) 518-7391
Entity
Organization
Contact information
Practice address
101 MAIN ST N, MIDDLETON, TN 38052-3433
(731) 472-2147
(731) 472-2148
Mailing address
101 MAIN ST N, MIDDLETON, TN 38052-3433
(731) 472-2147
(731) 472-2148
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
17787
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q001019
—
TN
Enumeration date
03/26/2018
Last updated
02/08/2019
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