| Organization Name: | NEWBERN MEDICAL CLINIC, PC |
| NPI Number: | 1790978294 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BEVERLY MCCANN (OWNER/PRESIDENT) |
| Mailing Address: | 105 N Monroe St Newbern |
| State: | TN US |
| Postal Code: | 380591214 |
| Phone Number: | 7316270734 |
| Fax Number: | 7316270736 |
| NPI Enumeration Date: | 08/20/2007 |
| NPI Last Update Date: | 08/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | APN5297 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |