Organization
JTP ENTERPRISES, LLC
Active
Other names
The Family Care Clinic of Sparta
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY W PERNELL CFNP (CEO)
(931) 707-7117
Entity
Organization
Contact information
Practice address
287 TURNTABLE RD., SPARTA, TN 38583
(931) 738-2000
(888) 337-7080
Mailing address
287 TURNTABLE RD., SPARTA, TN 38583
(931) 738-2000
(888) 337-7080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7811
TN
261QR1300X
Rural Health Clinic/Center
7811
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0448921
—
TN
01
—
1548460447
NPI
TN
Enumeration date
08/31/2012
Last updated
01/23/2014
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