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305 Grady Rd Ste B Etowah TN 37331-1911 | |
(423) 263-0722 | |
(833) 369-0949 |
Full Name | |
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Speciality | Clinic/Center |
Location | 305 Grady Rd Ste B, Etowah, Tennessee |
Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
Authorized Official Contact | 6159207000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | 305 Grady Rd Ste B Etowah TN 37331-1911 Ph: (423) 263-0722 |
NPI Number | 1508627175 |
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Provider Enumeration Date | 01/19/2024 |
Last Update Date | 09/16/2024 |
Medicare PECOS PAC ID | 2163490319 |
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Medicare Enrollment ID | O20240313000899 |
Identifier | Type | State | Issuer |
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1508627175 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Yung Gil Lee Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Grady Rd, Etowah, TN 37331 Phone: 423-263-5400 Fax: 423-263-0674 | |
Fast Pace Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Highway 441 N, Etowah, TN 37331 Phone: 423-604-4664 Fax: 423-604-4665 | |
Etowah Family Practice Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Grady Rd, Suite A, Etowah, TN 37331 Phone: 423-263-4500 Fax: 423-263-0045 | |