| Msmg Hima Fwch | |
|
300 Med Tech Pkwy Johnson City TN 37604-2277 | |
| (423) 431-1810 | |
| (423) 431-1811 |
| Full Name | Msmg Hima Fwch |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Med Tech Pkwy, 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 Hima Fwch 509 Med Tech Pkwy Suite 100 Johnson City TN 37604-2578 Ph: (423) 302-6882 | Msmg Hima Fwch 300 Med Tech Pkwy Johnson City TN 37604-2277 Ph: (423) 431-1810 |
| NPI Number | 1275851974 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 07/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275851974 | NPI | - | NPPES |
| 4344805 | Other | TN | BLUECARE |
| 1520040 | Medicaid | TN | |
| 1275851974 | Medicaid | VA | |
| 7100118880 | Medicaid | KY | |
| 7100161370 | Medicaid | KY | |
| CA5744 | Other | TN | RR MEDICARE |
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