| Msmg Fp Im Erw | |
|
630 Oneega Ln Suite A Erwin TN 37650-2197 | |
| (423) 735-5700 | |
| (423) 735-0967 |
| Full Name | Msmg Fp Im Erw |
|---|---|
| Speciality | Family Medicine |
| Location | 630 Oneega Ln, Erwin, Tennessee |
| Authorized Official Name and Position | Carl S Kilgore (PRESIDENT) |
| Authorized Official Contact | 4239155121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Msmg Fp Im Erw 630 Oneega Ln Suite A Erwin TN 37650-2197 Ph: (423) 735-5700 | Msmg Fp Im Erw 630 Oneega Ln Suite A Erwin TN 37650-2197 Ph: (423) 735-5700 |
| NPI Number | 1568705457 |
|---|---|
| Provider Enumeration Date | 03/29/2013 |
| Last Update Date | 02/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568705457 | NPI | - | NPPES |
| CA5744 | Other | TN | RR MEDICARE |
| 614862405 | Other | SD | DEPARTMENT OF LABOR |
| Q002802 | Medicaid | TN | |
| 1568705457 | Medicaid | VA |
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