| King's Way Family Medicine, Llc | |
|
318 Tusculum Blvd Greeneville TN 37745-3926 | |
| (423) 639-7700 | |
| (423) 639-7700 |
| Full Name | King's Way Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 318 Tusculum Blvd, Greeneville, Tennessee |
| Authorized Official Name and Position | Heather Olson (OWNER/PROVIDER) |
| Authorized Official Contact | 3868013083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| King's Way Family Medicine, Llc 318 Tusculum Blvd Greeneville TN 37745-3926 Ph: (386) 837-2969 | King's Way Family Medicine, Llc 318 Tusculum Blvd Greeneville TN 37745-3926 Ph: (423) 639-7700 |
| NPI Number | 1083178974 |
|---|---|
| Provider Enumeration Date | 01/25/2019 |
| Last Update Date | 01/30/2019 |
| Medicare PECOS PAC ID | 2466795612 |
|---|---|
| Medicare Enrollment ID | O20190510000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083178974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Heather Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215233812 PECOS PAC ID: 6709069313 Enrollment ID: I20121114000364 |
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