Provider Demographics
NPI:1306929005
Name:RUTHERFORD COUNTY MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:RUTHERFORD COUNTY MEDICAL ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWAUNCY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-793-9900
Mailing Address - Street 1:6001 JACKSON SQUARE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-2767
Mailing Address - Country:US
Mailing Address - Phone:615-793-9900
Mailing Address - Fax:615-793-9990
Practice Address - Street 1:6001 JACKSON SQ
Practice Address - Street 2:SUITE 100 FAMILY HEALTHCARE
Practice Address - City:LA VERGNE
Practice Address - State:TN
Practice Address - Zip Code:37086
Practice Address - Country:US
Practice Address - Phone:615-793-9900
Practice Address - Fax:615-793-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty