Organization
PRIME CARE MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DARRELL KING M.D. (PRESIDENT)
(731) 645-7932
Entity
Organization
Contact information
Practice address
1 PRIME CARE DR, SELMER, TN 38375-1864
(731) 645-7932
Mailing address
1 PRIME CARE DR, SELMER, TN 38375-1864
(731) 645-7932
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3717101
—
TN
05
—
3717102
—
TN
05
—
3717104
—
TN
01
—
CG1877
RAILROAD MEDICARE
—
Enumeration date
06/13/2006
Last updated
08/05/2009
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