Provider Demographics
NPI:1194551358
Name:FULL ACCESS MEDICAL PLLC
Entity type:Organization
Organization Name:FULL ACCESS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENGLISH
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:423-506-3781
Mailing Address - Street 1:16850 STATE HIGHWAY 58 S STE D3
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TN
Mailing Address - Zip Code:37322-5259
Mailing Address - Country:US
Mailing Address - Phone:423-506-0140
Mailing Address - Fax:
Practice Address - Street 1:16850 STATE HIGHWAY 58 S STE D3
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TN
Practice Address - Zip Code:37322-5259
Practice Address - Country:US
Practice Address - Phone:423-506-0140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty