Centennial Primary Care LLC

Organization Active NPI Family Medicine Physician · Lawrenceburg, TN

NPI 1265617674 · NPPES record last updated Jun 2, 2008

Key facts

NPI
1265617674
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CENTENNIAL PRIMARY CARE LLC
Practice address
1009 N Locust Ave
Suite 1
Lawrenceburg, TN 38464-2706
Phone
(931) 762-0531
Fax
(931) 762-0998
NPI assigned
Jan 3, 2008
Organization subpart
Yes
Parent organization (as reported)
HOSPITAL CORP. LLC

Authorized official

Name
Gary Duncan
Title
Vice President
Phone
(954) 767-5716

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

1009 N Locust Ave
Suite 1
Lawrenceburg, TN 38464-2706

Mailing address

1009 N Locust Ave
Suite 1
Lawrenceburg, TN 38464-2706
Phone (931) 762-0531

Other identifiers

IdentifierTypeStateIssuer
3370233MedicaidTN

Other providers in Lawrenceburg, TN

All providers in Lawrenceburg, TN · Family Medicine Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.