National Provider Identifier Database

LIBERTY MEDICAL CLINIC PC
Rural Health


Contact Information

LIBERTY MEDICAL CLINIC PC
4937 COLLEGE ST
BELLS, TN38006-3483
Phone: 731-663-3530
Fax: 731-663-3531
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Family 363LF0000X
Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for LIBERTY MEDICAL CLINIC PC

NPI Number 1790812956
Legal business name
LBN
LIBERTY MEDICAL CLINIC PC
Authorized official CHIZOBA NNAJI - (ASSISTANT)
Entity Organization
Organization subpart No
Enumeration date 02/27/2007
Last updated 05/08/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 0000032096
  • TN License #: 44-3974
  • TN License #: APN0000013147
  • TN Medicaid: 0443974
  • TN Medicaid: 3847625

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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