| Blount Gastroenterology Assoc Pc | |
|
1706 E Lamar Alexander Pkwy Maryville TN 37804-6204 | |
| (865) 983-0073 | |
| (865) 984-1731 |
| Full Name | Blount Gastroenterology Assoc Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1706 E Lamar Alexander Pkwy, Maryville, Tennessee |
| Authorized Official Name and Position | Stuart Craig Jarvis (PRESIDENT) |
| Authorized Official Contact | 8659830073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blount Gastroenterology Assoc Pc 1706 E Lamar Alexander Pkwy Maryville TN 37804-6204 Ph: (865) 983-0073 | Blount Gastroenterology Assoc Pc 1706 E Lamar Alexander Pkwy Maryville TN 37804-6204 Ph: (865) 983-0073 |
| NPI Number | 1144286709 |
|---|---|
| Provider Enumeration Date | 04/24/2006 |
| Last Update Date | 01/06/2010 |
| Medicare PECOS PAC ID | 4880639368 |
|---|---|
| Medicare Enrollment ID | O20050624000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144286709 | NPI | - | NPPES |
| 3381364 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | David C Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588627822 PECOS PAC ID: 2567522469 Enrollment ID: I20081121000712 |
| Provider Name | Edward F Brown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851354195 PECOS PAC ID: 4981874476 Enrollment ID: I20110818000503 |
| Provider Name | Michael John Coffey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225091564 PECOS PAC ID: 6305018896 Enrollment ID: I20111005000334 |
| Provider Name | Stuart Craig Jarvis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467415067 PECOS PAC ID: 4789629262 Enrollment ID: I20111006000274 |
| Provider Name | Richard Glen Cline |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942263280 PECOS PAC ID: 1759553134 Enrollment ID: I20111006000541 |
| Provider Name | Allison B Falin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982025763 PECOS PAC ID: 1153551429 Enrollment ID: I20140306000584 |
| Provider Name | Jenny O Smith |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912115460 PECOS PAC ID: 5294928198 Enrollment ID: I20140730002160 |
| Provider Name | Robby Ryan Klawitter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215147632 PECOS PAC ID: 0446414759 Enrollment ID: I20160920001714 |
| Provider Name | Isaac W Cline |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245592823 PECOS PAC ID: 3476780784 Enrollment ID: I20180717000925 |
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