Provider Demographics
NPI:1588996656
Name:MIDDLE TENNESSEE PRIMARY CARE PC
Entity type:Organization
Organization Name:MIDDLE TENNESSEE PRIMARY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-337-3843
Mailing Address - Street 1:2536 HIGHWAY 49 E
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-7159
Mailing Address - Country:US
Mailing Address - Phone:615-746-1557
Mailing Address - Fax:615-746-1615
Practice Address - Street 1:2536 HIGHWAY 49 E
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-7159
Practice Address - Country:US
Practice Address - Phone:615-746-1557
Practice Address - Fax:615-746-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty