Dr Paul Thomas Provance, MD | |
James H Quillen Va Medical Center, Mountain Home, TN 37684-4000 | |
(423) 926-1171 | |
Not Available |
Full Name | Dr Paul Thomas Provance |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 22 Years |
Location | James H Quillen Va Medical Center, Mountain Home, Tennessee |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760429740 | NPI | - | NPPES |
3825653 | Medicaid | TN | |
2571293 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 35.086268 (Ohio) | Secondary |
207R00000X | Internal Medicine | MD41434 (Tennessee) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellmont Holston Valley Medical Center | Kingsport, TN | Hospital |
Indian Path Community Hospital | Kingsport, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Holston Medical Group Pc | 8224935754 | 227 |
Dominion Health And Fitness, Inc | 3274570908 | 18 |
Holston Medical Group Pc | 8224935754 | 227 |
Entity Name | Holston Medical Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831110667 PECOS PAC ID: 8224935754 Enrollment ID: O20031216000416 |
Mailing Address | Practice Location Address |
---|---|
Dr Paul Thomas Provance, MD Po Box 4000, Mountain Home, TN 37684-4000 Ph: (423) 926-1171 | Dr Paul Thomas Provance, MD James H Quillen Va Medical Center, Mountain Home, TN 37684-4000 Ph: (423) 926-1171 |
Thomas Michael Roy, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: Corner Of Sidney And Lamont, 111-b, Mountain Home, TN 37614 Phone: 423-926-1171 | |
Dr. William Dralle, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: Corner Of Lamont And Sidney Streets, Mountain Home, TN 37684 Phone: 423-926-1171 | |
Dr. Angela Earlene May, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: Lamont Street, Mountain Home, TN 37684 Phone: 423-926-1171 | |
Dr. Joe Harold May, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: Va Medical Center, Building 69 Medical Service 111, Mountain Home, TN 37684 Phone: 423-926-1171 | |
Dr. Vinodini Krishnan, M.D Internal Medicine Medicare: Medicare Enrolled Practice Location: James H Quillen Vamc, Sydney&lamont Street, Mountain Home, TN 37684 Phone: 423-926-1171 | |
Dr. Gary Edward Bush, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: Va Medical Center, Mountain Home, Sidney And Lamont St, Mountain Home, TN 37684 Phone: 423-926-1171 Fax: 423-979-2829 | |
Dr. Judith Ellen Reid, MD MPH Internal Medicine Medicare: Medicare Enrolled Practice Location: James H. Quillen Va Medical Center, Corner Of Lamont & Veterans Way, Mountain Home, TN 37684 Phone: 423-926-1171 Fax: 423-979-3476 |