Class 'a' Clinic Llc | |
157 Highway 25 E Newport TN 37821-8157 | |
(423) 720-9111 | |
(423) 301-5756 |
Full Name | Class 'a' Clinic Llc |
---|---|
Speciality | Family Medicine |
Location | 157 Highway 25 E, Newport, Tennessee |
Authorized Official Name and Position | Charlene Crowder Matthews (PRACTITIONER) |
Authorized Official Contact | 4237209111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Class 'a' Clinic Llc 157 Highway 25 E Newport TN 37821-8157 Ph: (423) 720-9111 | Class 'a' Clinic Llc 157 Highway 25 E Newport TN 37821-8157 Ph: (423) 720-9111 |
NPI Number | 1073095154 |
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Provider Enumeration Date | 09/05/2018 |
Last Update Date | 09/04/2020 |
Medicare PECOS PAC ID | 5698108827 |
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Medicare Enrollment ID | O20191202002790 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073095154 | NPI | - | NPPES |
Q038489 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | 16835 (Tennessee) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Charlene Matthews |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447503842 PECOS PAC ID: 9537313630 Enrollment ID: I20130124000411 |
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