Crossville Medical Group Pa

LBN: Crossville Medical Group Pa
Crossville Medical Group Pa is an health care organization with primary practice located at 100 Lantana Rd Suite 202, Crossville TN 38555-1903. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Crossville Medical Group Pa can be contacted via phone (931) 484-5141, or through Burton, Gary via phone (931) 484-5141.

Contact Information

Primary practice address
100 Lantana Rd Suite 202 Crossville TN 38555-1903
Phone: (931) 484-5141
Fax: (931) 484-5620
Website:
Map and Directions
Authorized official contact:
Name: Burton, Gary
Phone: (931) 484-5141

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1053414698
LBN Legal business name Crossville Medical Group Pa
DBA Doing business as
Authorized official Burton, Gary
Entity Organization
Organization subpart 1 No
Enumeration date Sep 7th, 2006
Last updated Nov 19th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053414698 NPPES
Tennessee MEDICAID 3370906

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