Covenant Pediatrics, Pllc | |
421 Old Riceville Rd Ste 2 Athens TN 37303-3074 | |
(423) 744-8755 | |
(423) 744-8568 |
Full Name | Covenant Pediatrics, Pllc |
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Speciality | Clinic/Center |
Location | 421 Old Riceville Rd Ste 2, Athens, Tennessee |
Authorized Official Name and Position | Omer Breeden (BUSINESS MANAGER) |
Authorized Official Contact | 4237448755 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Covenant Pediatrics, Pllc 421 Old Riceville Rd Ste 2 Athens TN 37303-3074 Ph: (423) 744-8755 | Covenant Pediatrics, Pllc 421 Old Riceville Rd Ste 2 Athens TN 37303-3074 Ph: (423) 744-8755 |
NPI Number | 1659670412 |
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Provider Enumeration Date | 03/19/2011 |
Last Update Date | 05/23/2022 |
Medicare PECOS PAC ID | 5092196261 |
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Medicare Enrollment ID | O20220719002303 |
Identifier | Type | State | Issuer |
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1659670412 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | MD19704 (Tennessee) | Primary |
Donald H. Watters Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 Cook Dr, Suite 200, Athens, TN 37303 Phone: 423-507-8369 Fax: 423-507-8387 | |