Doctor Mike LLC
NPI #1245055227 in Fayetteville, Tennessee
Provider Information
- NPI Number
- 1245055227
- Entity Type
- Organization
- Organization Name
- Doctor Mike LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 15, 2024
- Last Updated
- Nov 15, 2024
Practice Location
- Address
- 305 COLLEGE ST W
- City
- Fayetteville
- State
- Tennessee
- ZIP Code
- 37334-2911
- Phone
- (931) 227-4984
Authorized Official
- Name
- MICHAEL PETER LOIACONO, MD
- Title
- MD/OWNER
- Phone
- (931) 227-6091
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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