| Msmg Extended Care Jc | |
|
408 N State Of Franklin Rd Suite 24 A Johnson City TN 37604-6089 | |
| (423) 431-1810 | |
| (423) 431-1811 |
| Full Name | Msmg Extended Care Jc |
|---|---|
| Speciality | Internal Medicine |
| Location | 408 N State Of Franklin Rd, Johnson City, Tennessee |
| Authorized Official Name and Position | Carl Steven Kilgore (PRESIDENT) |
| Authorized Official Contact | 4239155100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Msmg Extended Care Jc 509 Med Tech Pkwy Suite 100 Johnson City TN 37604-2578 Ph: (423) 302-6882 | Msmg Extended Care Jc 408 N State Of Franklin Rd Suite 24 A Johnson City TN 37604-6089 Ph: (423) 431-1810 |
| NPI Number | 1316357593 |
|---|---|
| Provider Enumeration Date | 04/28/2014 |
| Last Update Date | 07/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316357593 | NPI | - | NPPES |
| 1316357593 | Medicaid | VA | |
| 1534067 | Medicaid | TN |
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