Organization Name: | MOUNTAIN FAMILY MEDICAL, PLLC |
NPI Number: | 1992983381 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA KAY WRIGHT (ADVANCE PRACTICE NURSE) |
Mailing Address: | 1807 Taft Hwy Suite 3 Signal Mtn |
State: | TN US |
Postal Code: | 373773528 |
Phone Number: | 4238864942 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2008 |
NPI Last Update Date: | 03/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | APN0000012169 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |