| East Wood Clinic Pllc | |
|
1323 East Wood Street Paris TN 38242-4421 | |
| (731) 642-2011 | |
| (731) 644-2758 |
| Full Name | East Wood Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1323 East Wood Street, Paris, Tennessee |
| Authorized Official Name and Position | Joshua David Roberts (ADMINISTRATOR) |
| Authorized Official Contact | 7316418728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Wood Clinic Pllc 1323 East Wood Street Paris TN 38242-4421 Ph: (731) 642-2011 | East Wood Clinic Pllc 1323 East Wood Street Paris TN 38242-4421 Ph: (731) 642-2011 |
| NPI Number | 1073606778 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 10/08/2021 |
| Medicare PECOS PAC ID | 0143249839 |
|---|---|
| Medicare Enrollment ID | O20051111000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073606778 | NPI | - | NPPES |
| 3731888 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Rodney S Whitby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982797536 PECOS PAC ID: 8426077652 Enrollment ID: I20051117000122 |
| Provider Name | James W Mcgee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053407890 PECOS PAC ID: 3779502901 Enrollment ID: I20051117000132 |
| Provider Name | Douglas S Summers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710072392 PECOS PAC ID: 8628097284 Enrollment ID: I20051117000142 |
| Provider Name | Philip W Nanney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124112602 PECOS PAC ID: 2264451491 Enrollment ID: I20051117000196 |
| Provider Name | Bethany Lynn Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710371117 PECOS PAC ID: 5890008460 Enrollment ID: I20181023003077 |
| Provider Name | Joseph Michael Mcclure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467111377 PECOS PAC ID: 3678965696 Enrollment ID: I20220124002043 |
| Provider Name | Allie Nicole Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861989444 PECOS PAC ID: 5890158166 Enrollment ID: I20230905001083 |
| Provider Name | Stephanie Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285808097 PECOS PAC ID: 8527297415 Enrollment ID: I20240227004273 |
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