| Healthstar Physicians, Pc | |
|
657 E Broadway Blvd Suite C Jefferson City TN 37760-4948 | |
| (865) 475-9062 | |
| (865) 475-9063 |
| Full Name | Healthstar Physicians, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 657 E Broadway Blvd, Jefferson City, Tennessee |
| Authorized Official Name and Position | Donald L Lee (CEO) |
| Authorized Official Contact | 4235815925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthstar Physicians, Pc 657 E Broadway Blvd Suite C Jefferson City TN 37760-4948 Ph: (865) 475-9062 | Healthstar Physicians, Pc 657 E Broadway Blvd Suite C Jefferson City TN 37760-4948 Ph: (865) 475-9062 |
| NPI Number | 1205226032 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 02/02/2015 |
| Medicare PECOS PAC ID | 5890690978 |
|---|---|
| Medicare Enrollment ID | O20150327002496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205226032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD27663 (Tennessee) | Primary |
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