Lakeway Urgent Care | |
460 Medical Park Dr Suite 103 Lenoir City TN 37772-5782 | |
(865) 271-0038 | |
(865) 271-0040 |
Full Name | Lakeway Urgent Care |
---|---|
Speciality | Family Medicine |
Location | 460 Medical Park Dr, Lenoir City, Tennessee |
Authorized Official Name and Position | John D. Sanabria (OWNER/PRESIDENT) |
Authorized Official Contact | 8652710038 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lakeway Urgent Care 460 Medical Park Dr Suite 103 Lenoir City TN 37772-5782 Ph: (865) 271-0038 | Lakeway Urgent Care 460 Medical Park Dr Suite 103 Lenoir City TN 37772-5782 Ph: (865) 271-0038 |
NPI Number | 1891110433 |
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Provider Enumeration Date | 02/19/2014 |
Last Update Date | 02/19/2014 |
Medicare PECOS PAC ID | 0244456846 |
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Medicare Enrollment ID | O20140716001688 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891110433 | NPI | - | NPPES |
3814709 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 28120 (Tennessee) | Primary |
Provider Name | John Sanabria |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477594521 PECOS PAC ID: 8921224452 Enrollment ID: I20140718001270 |
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