Healthcare Provider Details

I. General information

NPI: 1134324510
Provider Name (Legal Business Name): WOMENS CENTER OF EAST TENNESSEE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N MEADOWS DR STE B
ATHENS TN
37303-4172
US

IV. Provider business mailing address

2301 N OCOEE ST STE A
CLEVELAND TN
37311-3869
US

V. Phone/Fax

Practice location:
  • Phone: 423-507-8067
  • Fax: 423-507-0952
Mailing address:
  • Phone: 423-339-1400
  • Fax: 423-339-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER MULLIN
Title or Position: OWNER
Credential:
Phone: 423-339-1400