| Madisonville Intermediate School Based Clinic | |
|
1000 Green Rd Madisonville TN 37354-7062 | |
| (423) 442-2454 | |
| Not Available |
| Full Name | Madisonville Intermediate School Based Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Green Rd, Madisonville, Tennessee |
| Authorized Official Name and Position | Puspa Das (CEO) |
| Authorized Official Contact | 4234422622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madisonville Intermediate School Based Clinic Po Box 278 Madisonville TN 37354-0278 Ph: (423) 442-2622 | Madisonville Intermediate School Based Clinic 1000 Green Rd Madisonville TN 37354-7062 Ph: (423) 442-2454 |
| NPI Number | 1679821623 |
|---|---|
| Provider Enumeration Date | 08/23/2012 |
| Last Update Date | 08/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679821623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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