| Mancel Wakham Llc | |
|
1000 Bradford Way Ste 500 Kingston TN 37763-3126 | |
| (865) 621-3601 | |
| (865) 409-5733 |
| Full Name | Mancel Wakham Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Bradford Way Ste 500, Kingston, Tennessee |
| Authorized Official Name and Position | Mancel Wakhem (OWNER) |
| Authorized Official Contact | 8656213601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mancel Wakham Llc 1000 Bradford Way Ste 500 Kingston TN 37763-3126 Ph: (865) 621-3601 | Mancel Wakham Llc 1000 Bradford Way Ste 500 Kingston TN 37763-3126 Ph: (865) 621-3601 |
| NPI Number | 1487475067 |
|---|---|
| Provider Enumeration Date | 10/17/2024 |
| Last Update Date | 10/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487475067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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