Brookside Medical Center Pllc | |
5121 Ooltewah Ringgold Road Suite G Collegedale TN 37315 | |
(423) 238-0033 | |
Not Available |
Full Name | Brookside Medical Center Pllc |
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Speciality | Family Medicine |
Location | 5121 Ooltewah Ringgold Road, Collegedale, Tennessee |
Authorized Official Name and Position | Shirley Spears (ADMINISTRATOR) |
Authorized Official Contact | 4232380033 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Brookside Medical Center Pllc Po Box 793 Ooltewah TN 37363-0793 Ph: (423) 238-0033 | Brookside Medical Center Pllc 5121 Ooltewah Ringgold Road Suite G Collegedale TN 37315 Ph: (423) 238-0033 |
NPI Number | 1083637078 |
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Provider Enumeration Date | 07/25/2006 |
Last Update Date | 11/30/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083637078 | NPI | - | NPPES |
3735307 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |