Organization
COFFEE COUNTY INTERNAL MEDICINE,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DINESH AGNIHOTRI M.D. (PRESIDENT)
(931) 454-9090
Entity
Organization
Contact information
Practice address
1330 CEDAR LN, SUITE 1200, TULLAHOMA, TN 37388-2283
(931) 454-9090
(931) 454-0773
Mailing address
PO BOX 157, TULLAHOMA, TN 37388-0157
(931) 454-9090
(931) 454-0773
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39341
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3728587
MEDICARE GROUP NUMBER
—
05
—
3728587
—
TN
Enumeration date
12/27/2007
Last updated
12/28/2007
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