Organization
AMG-HILLSIDE LLC
Active
Other names
FOCUSED WOMENS HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B CLARK (DIVISION PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
1275 E COLLEGE ST, SUITE 1, PULASKI, TN 38478-4500
(931) 207-8668
(931) 363-3939
Mailing address
PO BOX 1178, PULASKI, TN 38478-1178
(931) 207-8668
(931) 207-8671
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511382
—
TN
01
—
4153524
BCBS GROUP
TN
01
—
CK2947
RR GROUP
TN
Enumeration date
10/07/2008
Last updated
09/17/2009
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