Provider Demographics
NPI:1063495083
Name:CARTHAGE FAMILY HEALTHCARE INC
Entity type:Organization
Organization Name:CARTHAGE FAMILY HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:ACNP
Authorized Official - Phone:615-735-3450
Mailing Address - Street 1:133 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-4004
Mailing Address - Country:US
Mailing Address - Phone:615-735-3450
Mailing Address - Fax:615-735-3460
Practice Address - Street 1:133 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-4004
Practice Address - Country:US
Practice Address - Phone:615-735-3450
Practice Address - Fax:615-735-3460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27451207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D40289Medicare UPIN
3891434Medicare ID - Type Unspecified