Organization
PREMIER MEDICAL GROUP PC
Active
Other names
PMedical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA LIVERETT (CHIEF FINANCIAL ADMINISTRATOR)
(931) 245-7000
Entity
Organization
Contact information
Practice address
490 DUNLOP LN, CLARKSVILLE, TN 37040-5007
(931) 245-7000
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-7000
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3164217
BCBS GROUP #
TN
01
—
CA4837
RR MEDICARE
TN
Enumeration date
04/04/2006
Last updated
09/23/2025
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