Fast Pace Medical Clinic PLLC

Organization Active NPI Dermatology Physician · Tullahoma, TN

NPI 1073013306 · NPPES record last updated Jun 21, 2024

Key facts

NPI
1073013306
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
FAST PACE MEDICAL CLINIC PLLC
Practice address
600 N Jackson St
Tullahoma, TN 37388-3542
Phone
(931) 253-1110
NPI assigned
Feb 13, 2018
Organization subpart
No

Authorized official

Name
Melissa Harlan
Title
Director
Phone
(615) 948-9639

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Fast Pace Medical Clinic PLLC (133 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207N00000X Yes
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X

Addresses

Primary practice location

600 N Jackson St
Tullahoma, TN 37388-3542

Mailing address

6550 Carothers Pkwy Ste 225
Franklin, TN 37067-6662
Phone (931) 253-1110

Other identifiers

IdentifierTypeStateIssuer
1515574MedicaidTN

Other providers in Tullahoma, TN

All providers in Tullahoma, TN · Dermatology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.