| Mahmood A Siddiqui Md Pc | |
|
144 Medical Center Dr. #b Copperhill TN 37317-5000 | |
| (423) 496-9214 | |
| (423) 496-7809 |
| Full Name | Mahmood A Siddiqui Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 144 Medical Center Dr. #b, Copperhill, Tennessee |
| Authorized Official Name and Position | Mahmood Abdul Siddiqui (PRESIDENT) |
| Authorized Official Contact | 4234969214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahmood A Siddiqui Md Pc Po Box 1162 Copperhill TN 37317-1162 Ph: (423) 496-9214 | Mahmood A Siddiqui Md Pc 144 Medical Center Dr. #b Copperhill TN 37317-5000 Ph: (423) 496-9214 |
| NPI Number | 1427070523 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 11/09/2007 |
| Medicare PECOS PAC ID | 6305941535 |
|---|---|
| Medicare Enrollment ID | O20070417000666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427070523 | NPI | - | NPPES |
| 3736177 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD26174 (Tennessee) | Primary |
| Provider Name | Mahmood A Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568439453 PECOS PAC ID: 0749293298 Enrollment ID: I20070417000665 |
| Provider Name | Stacie M Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164518502 PECOS PAC ID: 4880694389 Enrollment ID: I20130409000161 |
| Provider Name | Lisa Swafford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518420256 PECOS PAC ID: 1557694700 Enrollment ID: I20190604000594 |
| Provider Name | Kayla R Maddox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326811258 PECOS PAC ID: 8921457680 Enrollment ID: I20231207001167 |
Family Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 144 Medical Center Dr Ste C, Copperhill, TN 37317 Phone: 423-548-1500 Fax: 423-548-1604 | |
Copper Basin Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 144 Medical Center Dr, Bldg. C, Copperhill, TN 37317 Phone: 423-496-5511 Fax: 423-548-1520 | |
Copper Basin Family Practice Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 144 Medical Center Dr, Bldg C, Copperhill, TN 37317 Phone: 423-496-1788 Fax: 423-496-1776 | |
Ocoee Regional Health Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Cougar Dr, Copperhill, TN 37317 Phone: 423-338-8995 Fax: 423-338-8996 | |
Doctors Of General Practice And Healing Arts, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 144 Medical Center Dr Ste D2, Copperhill, TN 37317 Phone: 423-548-2000 Fax: 423-548-2002 | |
Grace Health Services Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 340 Main Street, Copperhill, TN 37317 Phone: 423-548-1000 Fax: 423-548-1002 |