| Ccd Medical Services Llc | |
|
228 N Fairmont Ave Morristown TN 37814-3768 | |
| (423) 586-6263 | |
| Not Available |
| Full Name | Ccd Medical Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 228 N Fairmont Ave, Morristown, Tennessee |
| Authorized Official Name and Position | David R Kragel (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4235866263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccd Medical Services Llc 228 N Fairmont Ave Morristown TN 37814-3768 Ph: (423) 586-6263 | Ccd Medical Services Llc 228 N Fairmont Ave Morristown TN 37814-3768 Ph: (423) 586-6263 |
| NPI Number | 1346963444 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 05/22/2024 |
| Medicare PECOS PAC ID | 7517335094 |
|---|---|
| Medicare Enrollment ID | O20221115002404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346963444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| Provider Name | Joel Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194783472 PECOS PAC ID: 7517943327 Enrollment ID: I20221027002153 |
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