Organization
AMG-HILLSIDE LLC
Active
Organization
AMG-HILLSIDE LLC
Active
Other names
GILES COUNTY INTERNAL MEDICINE ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CLARK (VICE PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
206 HILLSIDE DR, PULASKI, TN 38478-4566
(931) 363-0668
(931) 363-0670
Mailing address
206 HILLSIDE DR, PULASKI, TN 38478-4566
(931) 363-0668
(931) 363-0670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506700
—
TN
Enumeration date
06/09/2008
Last updated
10/28/2008
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