Grace Primary Care, Pc | |
950 Baker Hwy Suite 4 Huntsville TN 37756-4168 | |
(423) 663-4200 | |
(423) 663-4256 |
Full Name | Grace Primary Care, Pc |
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Speciality | Family Medicine |
Location | 950 Baker Hwy, Huntsville, Tennessee |
Authorized Official Name and Position | Timothy D. Smith (OWNER) |
Authorized Official Contact | 4236634200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grace Primary Care, Pc 950 Baker Hwy Suite 4 Huntsville TN 37756-4168 Ph: (423) 663-4200 | Grace Primary Care, Pc 950 Baker Hwy Suite 4 Huntsville TN 37756-4168 Ph: (423) 663-4200 |
NPI Number | 1992742605 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 01/04/2010 |
Medicare PECOS PAC ID | 3971544131 |
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Medicare Enrollment ID | O20050518000233 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992742605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 3717835 (Tennessee) | Primary |
Provider Name | Timothy D Smith |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1720021660 PECOS PAC ID: 8426099680 Enrollment ID: I20050520000140 |
Provider Name | Karla S West |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689832271 PECOS PAC ID: 8628149317 Enrollment ID: I20080624000682 |
Provider Name | Lori B Weathers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740300516 PECOS PAC ID: 7416092176 Enrollment ID: I20100305000057 |
Summit Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 Baker Hwy Unit 4, Huntsville, TN 37756 Phone: 423-663-4200 Fax: 423-663-4256 | |
Crossroads Family Medicine, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 Baker Hwy, Huntsville, TN 37756 Phone: 404-266-9876 Fax: 404-266-2669 |