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395 Daugherty Spring Rd Tellico Plains TN 37385-5604 | |
| (423) 253-3551 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 395 Daugherty Spring Rd, Tellico Plains, Tennessee |
| Authorized Official Name and Position | Puspa Das (CEO) |
| Authorized Official Contact | 4234427268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 278 Madisonville TN 37354-0278 Ph: (423) 442-2622 | 395 Daugherty Spring Rd Tellico Plains TN 37385-5604 Ph: (423) 253-3551 |
| NPI Number | 1407104458 |
|---|---|
| Provider Enumeration Date | 08/23/2012 |
| Last Update Date | 08/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407104458 | 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 |