| Pma Surgery Center Llc | |
|
101 Med Tech Pkwy Suite 205 Johnson City TN 37604-4007 | |
| (423) 232-9420 | |
| (423) 232-9425 |
| Full Name | Pma Surgery Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | 101 Med Tech Pkwy, Johnson City, Tennessee |
| Authorized Official Name and Position | William Turney Williams (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4232326120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pma Surgery Center Llc 101 Med Tech Pkwy Suite 205 Johnson City TN 37604-4007 Ph: (423) 232-9420 | Pma Surgery Center Llc 101 Med Tech Pkwy Suite 205 Johnson City TN 37604-4007 Ph: (423) 232-9420 |
| NPI Number | 1548422355 |
|---|---|
| Provider Enumeration Date | 07/02/2008 |
| Last Update Date | 07/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548422355 | NPI | - | NPPES |
| 100048318 | Other | TN | PHP TENNCARE |
| 0007949702 | Other | TN | AETNA |
| 3288982 | Medicaid | TN | |
| 702040581 | Other | CARITEN | |
| 604059200 | Other | US DEPT OF LABOR | |
| P00188946 | Other | MEDICARE RAILROAD | |
| TN010 | Other | UNITED HEALTHCARE OF THE NEW RIVER VALLEY | |
| 4097786 | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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