| Etmc Physician Group Inc. | |
|
100 Municipal Dr Ste 300 Gun Barrel City TX 75156-3703 | |
| (903) 713-1574 | |
| Not Available |
| Full Name | Etmc Physician Group Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Municipal Dr Ste 300, Gun Barrel City, Texas |
| Authorized Official Name and Position | Stephen C. Petrovich (EVP, GENERAL COUNSEL) |
| Authorized Official Contact | 6152963594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etmc Physician Group Inc. 1 Burton Hills Blvd Ste 250 Nashville TN 37215-6195 Ph: (615) 296-3594 | Etmc Physician Group Inc. 100 Municipal Dr Ste 300 Gun Barrel City TX 75156-3703 Ph: (903) 713-1574 |
| NPI Number | 1689241945 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 06/07/2021 |
| Medicare PECOS PAC ID | 4486915600 |
|---|---|
| Medicare Enrollment ID | O20210909003136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689241945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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