Healthcare Provider Details
I. General information
NPI: 1750620019
Provider Name (Legal Business Name): MAUGHON URGENT CARE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2013
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1015 E PARKWAY
GATLINBURG TN
37738-5057
US
IV. Provider business mailing address
1015 E PARKWAY
GATLINBURG TN
37738-5057
US
V. Phone/Fax
- Phone: 865-436-7267
- Fax: 865-430-4179
- Phone: 865-436-7267
- Fax: 865-430-4179
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
M
MAUGHON
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 865-436-7267