| Open Door Primary Care & Wellness | |
|
228 N Fairmont Ave Morristown TN 37814-3768 | |
| (865) 236-0425 | |
| Not Available |
| Full Name | Open Door Primary Care & Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 228 N Fairmont Ave, Morristown, Tennessee |
| Authorized Official Name and Position | Cristy Anne Stallings (CO-OWNER) |
| Authorized Official Contact | 8652360425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Door Primary Care & Wellness Po Box 2023 Morristown TN 37816-2023 Ph: (865) 236-0425 | Open Door Primary Care & Wellness 228 N Fairmont Ave Morristown TN 37814-3768 Ph: (865) 236-0425 |
| NPI Number | 1386359446 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Medicare PECOS PAC ID | 1658744750 |
|---|---|
| Medicare Enrollment ID | O20230309002396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386359446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Cristy Stallings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639562937 PECOS PAC ID: 3678894805 Enrollment ID: I20150601000216 |
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