Eastside Family Medical Clinic

LBN: Lisa A Weaver
Eastside Family Medical Clinic is an health care organization with primary practice located at 104 Ivy Ln , Pulaski TN 38478-4550. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Lisa A Weaver can be contacted via phone (931) 424-1330, or through Weaver, Lisa Ann via phone (931) 424-1330.

Contact Information

Primary practice address
104 Ivy Ln Pulaski TN 38478-4550
Phone: (931) 424-1330
Fax: (931) 424-0019
Website:
Map and Directions
Authorized official contact:
Name: Weaver, Lisa Ann Advanced Practice Nurse (APN)
Phone: (931) 424-1330

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1659447654
LBN Legal business name Lisa A Weaver
DBA Doing business as Eastside Family Medical Clinic
Authorized official Weaver, Lisa Ann Advanced Practice Nurse (APN)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2006
Last updated Feb 2nd, 2015 - about 11 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 1659447654 NPPES
Tennessee MEDICAID 3710887

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