| Etowah Family Practice Plc | |
|
305 Grady Rd Suite A Etowah TN 37331-1903 | |
| (423) 263-4500 | |
| (423) 263-0045 |
| Full Name | Etowah Family Practice Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 305 Grady Rd, Etowah, Tennessee |
| Authorized Official Name and Position | James B Durkin (OWNER) |
| Authorized Official Contact | 4232634500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Etowah Family Practice Plc 305 Grady Rd Suite A Etowah TN 37331-1903 Ph: (423) 263-4500 | Etowah Family Practice Plc 305 Grady Rd Suite A Etowah TN 37331-1903 Ph: (423) 263-4500 |
| NPI Number | 1700913365 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 11/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700913365 | NPI | - | NPPES |
| 2308972 | Other | TN | CIGNA |
| 4051202 | Other | TN | BCBS |
| 7892455 | Other | TN | AETNA |
| 3880122 | Medicaid | TN | |
| P00092170 | Other | TN | RR MEDICARE |
| TN0101 | Other | TN | UHC/JD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000036878 (Tennessee) | Primary |
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