Organization
CLEARWATER INVESTMENTS INC BYRDSTOWN MEDICAL
Active
Other names
Byrdstown Medical Center, PLLC, Byrdstown Medical, Mason Farms Byrdstown Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEEDEE JOHNSON (CREDENTIALING / SYSTEMS ADMIN)
(931) 864-3187
Entity
Organization
Contact information
Practice address
8401 HWY 111, BYRDSTOWN, TN 38549-1006
(931) 864-3187
(931) 864-7102
Mailing address
8401 HWY 111, BYRDSTOWN, TN 38549-1006
(931) 864-3187
(931) 864-7102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3714746
—
TN
Enumeration date
08/09/2006
Last updated
02/11/2024
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