| |
2145 Jacksboro Pike La Follette TN 37766-3003 | |
(423) 907-1700 | |
(423) 907-1711 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2145 Jacksboro Pike, La Follette, Tennessee |
Authorized Official Name and Position | Paula M Lalor (DIRECTOR/DELEGATED OFFICIAL) |
Authorized Official Contact | 6292153953 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 743615 Atlanta GA 30374-3615 Ph: (423) 907-1700 | 2145 Jacksboro Pike La Follette TN 37766-3003 Ph: (423) 907-1700 |
NPI Number | 1639183353 |
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Provider Enumeration Date | 07/28/2006 |
Last Update Date | 03/29/2021 |
Medicare PECOS PAC ID | 3173795168 |
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Medicare Enrollment ID | O20111121000369 |
Identifier | Type | State | Issuer |
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1639183353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Eastlake Medical, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2205 Jacksboro Pike, La Follette, TN 37766 Phone: 423-352-6500 Fax: 423-352-6501 | |
Mercy Cardiology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 E Central Ave, Ste 102, La Follette, TN 37766 Phone: 423-907-1740 | |
Visavis Health Care Medical Group Of Tn Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 136 Davis Ln, La Follette, TN 37766 Phone: 929-491-7333 | |
Wynn Habersham Community Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1037 Stinking Creek Rd, La Follette, TN 37766 Phone: 423-784-5110 |