| Optimum Primary Care Pc | |
|
444 Clinchfield St Suite 303 Kingsport TN 37660-3606 | |
| (423) 914-3195 | |
| (423) 230-2818 |
| Full Name | Optimum Primary Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 444 Clinchfield St, Kingsport, Tennessee |
| Authorized Official Name and Position | Mack Lynn Hicks (PHYSICIAN) |
| Authorized Official Contact | 4239143195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Primary Care Pc 444 Clinchfield St Suite 303 Kingsport TN 37660-3606 Ph: () - | Optimum Primary Care Pc 444 Clinchfield St Suite 303 Kingsport TN 37660-3606 Ph: (423) 914-3195 |
| NPI Number | 1952728289 |
|---|---|
| Provider Enumeration Date | 03/25/2014 |
| Last Update Date | 03/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952728289 | NPI | - | NPPES |
| 3024432 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000015018 (Tennessee) | Primary |
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