Provider Demographics
NPI:1902353444
Name:HH PHYSICIAN CARE-ELKTON TENNESSEE
Entity Type:Organization
Organization Name:HH PHYSICIAN CARE-ELKTON TENNESSEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-265-8818
Mailing Address - Street 1:PO BOX 21007
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35813-5007
Mailing Address - Country:US
Mailing Address - Phone:256-801-6036
Mailing Address - Fax:256-801-6218
Practice Address - Street 1:1446 BRYSON ROAD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:TN
Practice Address - Zip Code:38449
Practice Address - Country:US
Practice Address - Phone:931-468-2102
Practice Address - Fax:931-468-2103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE AUTHORITY OF THE CITY OF HUNTSVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-01
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43038207R00000X
TN21295207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty