Organization
FAST PACE MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BENSON (COO)
(931) 253-1110
Entity
Organization
Contact information
Practice address
4152 W STATE ROAD, HANOVER, IN 47243
(931) 253-1110
(931) 722-9919
Mailing address
PO BOX 1258, WAYNESBORO, TN 38485-1258
(931) 253-1110
(931) 722-9919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300036022
—
IN
Enumeration date
02/15/2018
Last updated
03/11/2024
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