| Specialty Medical Services, Inc | |
|
188 16th Ave Ste 104 Dayton TN 37321-1038 | |
| (423) 570-0097 | |
| (423) 570-0808 |
| Full Name | Specialty Medical Services, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 188 16th Ave Ste 104, Dayton, Tennessee |
| Authorized Official Name and Position | Edward D Johnson (DOCTOR) |
| Authorized Official Contact | 4235700097 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Medical Services, Inc 188 16th Ave Ste 104 Dayton TN 37321-1038 Ph: (423) 570-0097 | Specialty Medical Services, Inc 188 16th Ave Ste 104 Dayton TN 37321-1038 Ph: (423) 570-0097 |
| NPI Number | 1215056171 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215056171 | NPI | - | NPPES |
| 4053237 | Other | TN | BC BS |
| 3376010 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD13288 (Tennessee) | Primary |
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