| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 7744 Conner Road, Powell, Tennessee |
| Authorized Official Name and Position | Ed Curtis (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 8655844747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1225 E Weisgarber Rd Suite 200 Knoxville TN 37909-2604 Ph: (865) 584-4747 | 7744 Conner Road Powell TN 37849 Ph: (865) 546-9751 |
| NPI Number | 1609955970 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 10/10/2016 |
| Medicare PECOS PAC ID | 2860396330 |
|---|---|
| Medicare Enrollment ID | O20100930033089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609955970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 19397 (Tennessee) | Primary |
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