Provider Demographics
NPI:1053019679
Name:COORDINATED MEDICAL I PLLC
Entity type:Organization
Organization Name:COORDINATED MEDICAL I PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-454-8146
Mailing Address - Street 1:210 ATHENS WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1308
Mailing Address - Country:US
Mailing Address - Phone:833-633-1295
Mailing Address - Fax:615-270-5011
Practice Address - Street 1:39555 ORCHARD HILL PL STE 600
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5381
Practice Address - Country:US
Practice Address - Phone:833-633-1295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty