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NPI Code Detail

MEDICARE: MEDICAL CARE LLC

MEDICARE: MEDICAL CARE LLC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1346419272
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL CARE LLC
Provider Business Mailing Address
First Line : 401 E MAIN ST
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-4877
Country : US
Telephone Number : 423-431-0512
Fax Number : 423-722-2060
Provider Business Practice Location Address
First Line : 1500 W ELK AVE
Second Line :
City : ELIZABETHTON
State : TN
Zip : 37643-2654
Country : US
Telephone Number : 423-431-0512
Fax Number : 423-722-2060
Authorized Official
Title or Position : CREDENTIALING
Name : TAMMY HARDIN
Credential :
Telephone Number : 423-431-0512
Provider Enumeration Date : 02/25/2008
Last Update Date : 06/01/2015

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Directions to “MEDICAL CARE LLC ” Practice Location

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