| James Lee Davenport | |
|
306 Pine Hill Rd Elizabethton TN 37643-2920 | |
| (423) 542-4189 | |
| (423) 542-4181 |
| Full Name | James Lee Davenport |
|---|---|
| Speciality | Family Medicine |
| Location | 306 Pine Hill Rd, Elizabethton, Tennessee |
| Authorized Official Name and Position | James Lee Davenport (OWNER) |
| Authorized Official Contact | 4235424189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James Lee Davenport 306 Pine Hill Rd Elizabethton TN 37643-2920 Ph: (423) 542-4189 | James Lee Davenport 306 Pine Hill Rd Elizabethton TN 37643-2920 Ph: (423) 542-4189 |
| NPI Number | 1184746869 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 01/14/2010 |
| Medicare PECOS PAC ID | 1951438241 |
|---|---|
| Medicare Enrollment ID | O20100419000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184746869 | NPI | - | NPPES |
| 3379172 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34068 (Tennessee) | Primary |
| 207R00000X | Internal Medicine | 36009 (Tennessee) | Secondary |
| 208000000X | Pediatrics | 36009 (Tennessee) | Secondary |
| Provider Name | James L Davenport |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326106964 PECOS PAC ID: 2567599863 Enrollment ID: I20100419000286 |
| Provider Name | Michelle L Davenport |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497813026 PECOS PAC ID: 6103953401 Enrollment ID: I20100419000324 |
Mountain Empire Medical And Surgical Associates Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1503 W Elk Ave, Suite 8, Elizabethton, TN 37643 Phone: 423-542-0400 Fax: 423-542-0201 | |
Carter County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 E G St, Elizabethton, TN 37643 Phone: 423-543-2521 | |
Northeast Tennessee Medical Associates Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 Rogosin Dr, Elizabethton, TN 37643 Phone: 423-542-5505 Fax: 423-542-5573 | |
Msmg Im Eliz Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643 Phone: 423-547-2762 Fax: 423-542-8621 | |
Ballad Health Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1497 West Elk Ave, Suite 21, Elizabethton, TN 37643 Phone: 423-542-7420 Fax: 423-542-7425 | |
Medical Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 W Elk Ave, Elizabethton, TN 37643 Phone: 423-431-0512 Fax: 423-722-2060 |