Organization
EAST FORK MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK DEMPSEY HYDRICK II NP (MANAGING MEMBER)
(615) 855-7488
Entity
Organization
Contact information
Practice address
370 DOOLITTLE RD, #4, WOODBURY, TN 37190-1129
(615) 855-7488
Mailing address
322 SAVANNAH RDG, MURFREESBORO, TN 37127-8349
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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