Hyde Park Medical Group, Pllc

NPI #1043903990 in Smyrna, Tennessee

Provider Information

NPI Number: 1043903990
Entity Type: Organization
Organization Name: Hyde Park Medical Group, Pllc
Primary Specialty: Family Medicine
Enumeration Date: May 29, 2023
Last Updated: Nov 1, 2024

Practice Location

Address: 741 PRESIDENT PL STE 140
City: Smyrna
State: Tennessee
ZIP Code: 37167-6808
Phone: (615) 412-8662

Authorized Official

Name: DR. KHAISHA GIST, MD
Title: MEDICAL DIRECTOR
Phone: (773) 802-2723

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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