| Internal Medicine And Pediatric Associates Of Bristol Pc | |
|
350 Steeles Road Bristol TN 37620-9532 | |
| (423) 844-6700 | |
| (423) 844-6703 |
| Full Name | Internal Medicine And Pediatric Associates Of Bristol Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 350 Steeles Road, Bristol, Tennessee |
| Authorized Official Name and Position | Vicki L Moody (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4238446704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine And Pediatric Associates Of Bristol Pc 350 Steeles Rd Ste 2 Bristol TN 37620-9532 Ph: (423) 844-6700 | Internal Medicine And Pediatric Associates Of Bristol Pc 350 Steeles Road Bristol TN 37620-9532 Ph: (423) 844-6700 |
| NPI Number | 1093760902 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 09/24/2021 |
| Medicare PECOS PAC ID | 9335114875 |
|---|---|
| Medicare Enrollment ID | O20040830000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093760902 | NPI | - | NPPES |
| CG2912 | Other | SD | MEDICARE RAILROAD |
| 3707101 | Other | TN | TNCARE PN |
| CG2912 | Other | SD | MEDICARE RAILROAD # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Tennessee) | Secondary |
| 207R00000X | Internal Medicine | (Tennessee) | Primary |
| 208000000X | Pediatrics | (Tennessee) | Secondary |
| Provider Name | Shelby G Olds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205832169 PECOS PAC ID: 3274528799 Enrollment ID: I20040831000397 |
| Provider Name | Harry P Claybrook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801892765 PECOS PAC ID: 1759376270 Enrollment ID: I20111114000498 |
| Provider Name | Bernard P Grunstra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558367417 PECOS PAC ID: 6305831819 Enrollment ID: I20111115000691 |
| Provider Name | Jamie White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285110759 PECOS PAC ID: 9931445616 Enrollment ID: I20190117000811 |
| Provider Name | John Paul Blakley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194289298 PECOS PAC ID: 4981033644 Enrollment ID: I20200331002085 |
Broadmore Assisted Living Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 826 Meadow View Rd, Bristol, TN 37620 Phone: 423-764-4622 | |
Bristol Family Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 Midway St, Bristol, TN 37620 Phone: 423-968-5225 Fax: 423-764-8274 | |
Pac Of Tennessee Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1958 West State Street, Suite 2, Bristol, TN 37620 Phone: 423-573-1502 Fax: 423-217-0604 | |
Carol A Dewey Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 522 Alabama St, Bristol, TN 37620 Phone: 423-968-4444 | |
Integrated Health Concepts, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28 Midway St, Bristol, TN 37620 Phone: 423-573-9873 | |
Holston Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 Medical Park Blvd Ste 1500, Bristol, TN 37620 Phone: 423-990-2460 |