| Covenant Medcare Llc | |
|
15324 Rankin Avenue Dunlap TN 37327 | |
| (423) 949-9200 | |
| (423) 949-9203 |
| Full Name | Covenant Medcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15324 Rankin Avenue, Dunlap, Tennessee |
| Authorized Official Name and Position | Jonathan M Kerley (OWNER PHYSICIAN) |
| Authorized Official Contact | 4239499200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Medcare Llc Po Box 985 15324 Rankin Ave Dunlap TN 37327-0985 Ph: (423) 949-9200 | Covenant Medcare Llc 15324 Rankin Avenue Dunlap TN 37327 Ph: (423) 949-9200 |
| NPI Number | 1144428780 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 09/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144428780 | NPI | - | NPPES |
| 3726561 | Other | TN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | DO0000001427 (Tennessee) | Primary |
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