Organization
EXTENDCARE MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN DENNIS MD (MEDICAL DIRECTOR)
(615) 261-9106
Entity
Organization
Contact information
Practice address
2000 MALLORY LN STE 130-256, FRANKLIN, TN 37067-8209
(615) 261-9106
(615) 261-9106
Mailing address
2000 MALLORY LN STE 130-256, FRANKLIN, TN 37067-8209
(615) 261-9106
(615) 261-9106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37294
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3885918
—
TN
Enumeration date
07/12/2006
Last updated
11/28/2007
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