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717 Watkins Rd Maryville TN 37801-4598 | |
| (865) 980-7802 | |
| (865) 980-7804 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 717 Watkins Rd, Maryville, Tennessee |
| Authorized Official Name and Position | Terry Bragg (PRESIDENT) |
| Authorized Official Contact | 8659827802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
615 Leeper Pkwy Lenoir City TN 37772-6151 Ph: (865) 986-8600 | 717 Watkins Rd Maryville TN 37801-4598 Ph: (865) 980-7802 |
| NPI Number | 1205167509 |
|---|---|
| Provider Enumeration Date | 01/26/2010 |
| Last Update Date | 01/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205167509 | NPI | - | NPPES |
| 1510839 | Medicaid | TN |
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