| Organization Name: | CRAVENS MEDICAL CENTER, PLLC |
| NPI Number: | 1033135900 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN KEITH STUBBS (OFFICE MANAGER) |
| Mailing Address: | 189 Lantana Rd Crossville |
| State: | TN US |
| Postal Code: | 385554902 |
| Phone Number: | 9314560881 |
| Fax Number: | 9314561511 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 41045 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |