| East Tennessee Gastroenterology, Pllc | |
|
2404 Chambliss Ave Nw Cleveland TN 37311-3848 | |
| (423) 339-2000 | |
| Not Available |
| Full Name | East Tennessee Gastroenterology, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2404 Chambliss Ave Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | George Samuel (PRESIDENT) |
| Authorized Official Contact | 4233392000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tennessee Gastroenterology, Pllc 2404 Chambliss Ave Nw Cleveland TN 37311-3848 Ph: (423) 339-2000 | East Tennessee Gastroenterology, Pllc 2404 Chambliss Ave Nw Cleveland TN 37311-3848 Ph: (423) 339-2000 |
| NPI Number | 1326370784 |
|---|---|
| Provider Enumeration Date | 02/09/2010 |
| Last Update Date | 04/01/2013 |
| Medicare PECOS PAC ID | 4981897048 |
|---|---|
| Medicare Enrollment ID | O20101021000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326370784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 2102 (Tennessee) | Primary |
| Provider Name | George Alexander Samuel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528083151 PECOS PAC ID: 2466486956 Enrollment ID: I20101021000240 |
| Provider Name | Samantha Logan Spinks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649629049 PECOS PAC ID: 7416249727 Enrollment ID: I20160707000502 |
| Provider Name | Sherri Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609349737 PECOS PAC ID: 3375875214 Enrollment ID: I20191028000329 |
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