MEDICARE: FIRST CARE MEDICAL CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	24365	TN
2	208D00000X	General Practice Physician	9319	TN

General Provider Information

NPI Number	:	1306846449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CARE MEDICAL CENTER PC

Provider Business Mailing Address
First Line	:	108 W INSKIP DR
Second Line	:	STE B
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-4058
Country	:	US
Telephone Number	:	865-687-2277
Fax Number	:	865-689-5336

Provider Business Practice Location Address
First Line	:	108 W INSKIP DR
Second Line	:	STE B
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-4058
Country	:	US
Telephone Number	:	865-687-2277
Fax Number	:	865-689-5336

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CHAN MAK
Credential	:
Telephone Number	:	865-687-2277

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	04/16/2008

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Directions to “FIRST CARE MEDICAL CENTER PC ” Practice Location

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