Organization
ALLIANCE MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNA FORSYTHE (DIRECTOR)
(731) 512-0104
Entity
Organization
Contact information
Practice address
21 MERIDIAN SPRINGS DR, JACKSON, TN 38301-5900
(731) 421-8088
(731) 421-8091
Mailing address
21 MERIDIAN SPRINGS DR, JACKSON, TN 38301-5900
(731) 421-8088
(731) 421-8091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6012010
BCBST
TN
05
—
Q004761
—
TN
Enumeration date
03/13/2014
Last updated
07/18/2014
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