| Mpc | |
|
100 Stalling Ln Erwin TN 37650 | |
| (423) 743-4131 | |
| (423) 743-6314 |
| Full Name | Mpc |
|---|---|
| Speciality | General Practice |
| Location | 100 Stalling Ln, Erwin, Tennessee |
| Authorized Official Name and Position | Alan Cox (OWNER) |
| Authorized Official Contact | 4237678268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mpc 2603 Avondale Dr Johnson City TN 37604-1902 Ph: (423) 767-8268 | Mpc 100 Stalling Ln Erwin TN 37650 Ph: (423) 743-4131 |
| NPI Number | 1588140503 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 07/25/2018 |
| Medicare PECOS PAC ID | 0244576536 |
|---|---|
| Medicare Enrollment ID | O20190108000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588140503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 46691 (Tennessee) | Secondary |
| 208D00000X | General Practice | 46691 (Tennessee) | Primary |
| 208M00000X | Hospitalist | 46691 (Tennessee) | Secondary |
| Provider Name | Alan Lee Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003057068 PECOS PAC ID: 4284816067 Enrollment ID: I20110316000027 |
| Provider Name | Claudia C Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053586941 PECOS PAC ID: 0648440339 Enrollment ID: I20110907001567 |
| Provider Name | Deretsa Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881147692 PECOS PAC ID: 4981991569 Enrollment ID: I20160926001040 |
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