Provider Demographics
NPI:1043252620
Name:CHRISTIAN FAMILY MEDICINE, INC.
Entity type:Organization
Organization Name:CHRISTIAN FAMILY MEDICINE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-981-1901
Mailing Address - Street 1:79 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-4580
Mailing Address - Country:US
Mailing Address - Phone:731-635-8189
Mailing Address - Fax:731-635-8121
Practice Address - Street 1:79 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-4580
Practice Address - Country:US
Practice Address - Phone:731-635-8189
Practice Address - Fax:731-635-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3727405Medicaid
TN3727405Medicaid
TN443951Medicare Oscar/Certification