| Newbern Medical Clinic, Pc | |
|
105 N Monroe St Newbern TN 38059-1214 | |
| (731) 627-0734 | |
| (731) 627-0736 |
| Full Name | Newbern Medical Clinic, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 105 N Monroe St, Newbern, Tennessee |
| Authorized Official Name and Position | Beverly Mccann (OWNER/PRESIDENT) |
| Authorized Official Contact | 7316270734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newbern Medical Clinic, Pc 105 N Monroe St Newbern TN 38059-1214 Ph: (731) 627-0734 | Newbern Medical Clinic, Pc 105 N Monroe St Newbern TN 38059-1214 Ph: (731) 627-0734 |
| NPI Number | 1790978294 |
|---|---|
| Provider Enumeration Date | 08/20/2007 |
| Last Update Date | 08/20/2007 |
| Medicare PECOS PAC ID | 7214995448 |
|---|---|
| Medicare Enrollment ID | O20041220001088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790978294 | NPI | - | NPPES |
| 3727670 | Other | TN | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | APN5297 (Tennessee) | Primary |
| Provider Name | Beverly D Mccann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275634214 PECOS PAC ID: 5597734061 Enrollment ID: I20040930000937 |
| Provider Name | Kelly A Harden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194723056 PECOS PAC ID: 2567542731 Enrollment ID: I20071231000516 |
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