Basic Information
| Provider Information | |||||||||
| NPI: | 1578563409 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRST CHOICE HEALTH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 184 PROSSER RD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384644233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9317621800 | ||||||||
| FaxNumber: | 9317629155 | ||||||||
| Practice Location | |||||||||
| Address1: | 184 PROSSER RD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384644233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9317621800 | ||||||||
| FaxNumber: | 9317629155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 09/19/2007 | ||||||||
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| AuthorizedOfficialLastName: | EVERETT | ||||||||
| AuthorizedOfficialFirstName: | LEON | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9317621800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.