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401 W Washington Ave Athens TN 37303-3468 | |
(423) 745-6610 | |
(423) 745-6360 |
Full Name | |
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Speciality | Clinic/Center |
Location | 401 W Washington Ave, Athens, Tennessee |
Authorized Official Name and Position | Gregory Brian Cain (OWNER) |
Authorized Official Contact | 4234422121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 808 Kingston TN 37763-0808 Ph: (865) 224-7172 | 401 W Washington Ave Athens TN 37303-3468 Ph: (423) 745-6610 |
NPI Number | 1326768870 |
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Provider Enumeration Date | 09/02/2022 |
Last Update Date | 11/04/2024 |
Medicare PECOS PAC ID | 6507037645 |
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Medicare Enrollment ID | O20220927004013 |
Identifier | Type | State | Issuer |
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1326768870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Donald H. Watters Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 Cook Dr, Suite 200, Athens, TN 37303 Phone: 423-507-8369 Fax: 423-507-8387 | |