Organization
AFC PHYSICIANS OF TENNESSEE, PC
Active
Parent organization
AFC PHYSICIANS OF TENNESSEE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AFC PHYSICIANS OF TENNESSEE, PC
Authorized official
MR. RANDY JOHANSEN (PRESIDENT)
(054) 212-1012
Entity
Organization
Contact information
Practice address
1763 MADISON STREET COMMONS, CLARKSVILLE, TN 37043
(931) 278-8000
(931) 278-8004
Mailing address
3700 CAHABA BEACH RD, BIRMINGHAM, AL 35242-5225
(205) 403-8902
(205) 421-2109
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G702075
MCR PTAN
TN
Enumeration date
11/12/2013
Last updated
06/12/2020
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