Organization
FAMILY AND CHILDRENS CLINIC OF MACON COUNTY
Active
Organization
FAMILY AND CHILDRENS CLINIC OF MACON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERNA BAIN MD (OWNER)
(615) 325-5000
Entity
Organization
Contact information
Practice address
105 E MARKET ST, PORTLAND, TN 37148-1228
(615) 325-5000
(615) 323-8400
Mailing address
105 E MARKET ST, PORTLAND, TN 37148-1228
(615) 325-5000
(615) 323-8400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31162
TN
208000000X
Pediatrics Physician
31162
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3711400
—
TN
Enumeration date
10/22/2007
Last updated
12/19/2014
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