| Campbell Station Primary Care Associates | |
|
11541 Kingston Pike 101 Knoxville TN 37934-3918 | |
| (865) 675-7522 | |
| (865) 671-3196 |
| Full Name | Campbell Station Primary Care Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 11541 Kingston Pike 101, Knoxville, Tennessee |
| Authorized Official Name and Position | Robert M Martin (CHIEF MANAGER) |
| Authorized Official Contact | 8656757522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Campbell Station Primary Care Associates 11541 Kingston Pike 101 Knoxville TN 37934-3918 Ph: (865) 675-7522 | Campbell Station Primary Care Associates 11541 Kingston Pike 101 Knoxville TN 37934-3918 Ph: (865) 675-7522 |
| NPI Number | 1659403590 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1658321245 |
|---|---|
| Medicare Enrollment ID | O20050201000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659403590 | NPI | - | NPPES |
| 3728422 | Medicaid | TN | |
| 4029196 | Other | TN | BCBST GROUP |
| TN103 | Other | TN | UNITED HEALTH RIVER VALL |
| 100034888 | Other | TN | PHP CARITEN ID NUMBER |
| 190646 | Other | TN | UNITED HEALTHCARE GROUP # |
| 7768236 | Other | TN | AETNA US HEALTHCARE ID |
| 4050284 | Other | TN | BLUECROSS BLUESHIELD OF T |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Tennessee) | Primary |
| Provider Name | Robert M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922004159 PECOS PAC ID: 9133191364 Enrollment ID: I20040809001122 |
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