Atoka Medical Clinic, Inc | |
60 Commercial Dr Atoka TN 38004-7042 | |
(901) 296-1156 | |
(901) 296-0430 |
Full Name | Atoka Medical Clinic, Inc |
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Speciality | Clinic/Center |
Location | 60 Commercial Dr, Atoka, Tennessee |
Authorized Official Name and Position | Katrina Jo Korszoloski (FAMILY NURSE PRACTITIONER, OWNER) |
Authorized Official Contact | 9012961156 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Atoka Medical Clinic, Inc 60 Commercial Dr Atoka TN 38004-7042 Ph: (901) 296-1156 | Atoka Medical Clinic, Inc 60 Commercial Dr Atoka TN 38004-7042 Ph: (901) 296-1156 |
NPI Number | 1104679299 |
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Provider Enumeration Date | 04/08/2024 |
Last Update Date | 01/22/2025 |
Medicare PECOS PAC ID | 7911445069 |
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Medicare Enrollment ID | O20240820002638 |
Identifier | Type | State | Issuer |
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1104679299 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Provider Name | Katrina J Korszoloski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417479965 PECOS PAC ID: 3173889094 Enrollment ID: I20210422003165 |
Comprehensive Primary Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 76 Capital Way, Suite C, Atoka, TN 38004 Phone: 901-840-1202 Fax: 901-840-1204 |