Organization
STATE OF TENNESSEE
Active
Other names
Gibson County Health Department Humboldt Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN BARNES (REGIONAL DIRECTOR)
(731) 421-6700
Entity
Organization
Contact information
Practice address
149 NORTH 12TH STREET, HUMBOLDT, TN 38343
(731) 784-5491
(731) 784-1726
Mailing address
149 NORTH 12TH STREET, HUMBOLDT, TN 38343
(731) 784-5491
(731) 784-1726
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4448184
—
TN
Enumeration date
01/11/2007
Last updated
08/25/2010
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