Organization
FAMILY MEDICAL CLINIC OF TREZEVANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH KAY LEGGETT FNP (OWNER)
(731) 200-3001
Entity
Organization
Contact information
Practice address
45 HURT ST, TREZEVANT, TN 38258-2505
(731) 207-0323
(731) 240-8065
Mailing address
45 HURT ST, TREZEVANT, TN 38258-2505
(731) 207-0323
(731) 240-8065
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q054230
—
TN
Enumeration date
10/30/2019
Last updated
03/31/2022
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