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401 Takoma Ave Greeneville TN 37743-4647 | |
| (423) 636-3151 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Takoma Ave, Greeneville, Tennessee |
| Authorized Official Name and Position | Todd J Dougan (CFO) |
| Authorized Official Contact | 4232308512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 37087 Baltimore MD 21297-3807 Ph: (423) 224-3250 | 401 Takoma Ave Greeneville TN 37743-4647 Ph: (423) 636-3151 |
| NPI Number | 1720105810 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 02/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720105810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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