Basic Information
| Provider Information | |||||||||
| NPI: | 1588851661 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICIANS MEDICAL CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1525 S CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371305510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152177236 | ||||||||
| FaxNumber: | 6152177238 | ||||||||
| Practice Location | |||||||||
| Address1: | 1525 S CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371305510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152177236 | ||||||||
| FaxNumber: | 6152177238 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2007 | ||||||||
| LastUpdateDate: | 11/28/2011 | ||||||||
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| AuthorizedOfficialLastName: | GLYNN | ||||||||
| AuthorizedOfficialFirstName: | MARTIN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6152177236 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | TN | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.