Provider Demographics
NPI:1538805023
Name:SCOTTS HILL MEDICAL CLINIC, INC
Entity type:Organization
Organization Name:SCOTTS HILL MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:731-549-1000
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-0187
Mailing Address - Country:US
Mailing Address - Phone:731-549-1000
Mailing Address - Fax:731-549-1011
Practice Address - Street 1:644 HIGHWAY 114 S
Practice Address - Street 2:
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-5023
Practice Address - Country:US
Practice Address - Phone:731-549-1000
Practice Address - Fax:731-549-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1154308849OtherFNP
TN1275168080OtherFNP
TN1871577684OtherFNP