| Psychiatric Associates Of Kingsport Llp | |
|
444 Clinchfield St Ste 101 Kingsport TN 37660-3859 | |
| (423) 392-6500 | |
| (423) 392-6504 |
| Full Name | Psychiatric Associates Of Kingsport Llp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 444 Clinchfield St Ste 101, Kingsport, Tennessee |
| Authorized Official Name and Position | Eric D Moffet (M.D. PARTNER) |
| Authorized Official Contact | 4233926500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Associates Of Kingsport Llp 444 Clinchfield St Ste 101 Kingsport TN 37660-3859 Ph: (423) 392-6500 | Psychiatric Associates Of Kingsport Llp 444 Clinchfield St Ste 101 Kingsport TN 37660-3859 Ph: (423) 392-6500 |
| NPI Number | 1750485322 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 07/07/2020 |
| Certification Date | 07/07/2020 |
| Medicare PECOS PAC ID | 8022299809 |
|---|---|
| Medicare Enrollment ID | O20110228000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750485322 | NPI | - | NPPES |
| 069099 | Other | VA | MOFFET BCVA |
| 3189819 | Medicaid | TN | |
| 0105831 | Other | TN | MOFFET BCTN |
| 0018152 | Other | TN | SMITH BCTN |
| 069098 | Other | VA | SMITH BCVA |
| 069097 | Other | VA | KUTTY BC VA |
| 3052859 | Medicaid | TN | |
| 0048066 | Other | TN | KUTTY BC TN |
| 3016081 | Medicaid | TN |
| Provider Name | Eric Moffet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609984178 PECOS PAC ID: 6406039916 Enrollment ID: I20111118000158 |
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