Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northside Medical Clinic, PC

Organization Family Medicine Physician · NPI 1083781595

Northside Medical Clinic, PC provides Family Medicine Physician services in Jackson, Tennessee. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

31 Hughes Dr
Jackson, TN 38305-1505 Not confirmed with CMS for 13 years — call before visiting
Phone: (731) 668-2800
Fax: (731) 668-6161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1083781595
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Blenis — Administrator · (731) 668-2800
NPI enumeratedNovember 29, 2006
Last updated in NPPESDecember 4, 2012
Mailing address31 Hughes Dr, Jackson, TN 38305-1505

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