Healthcare Provider Details

I. General information

NPI: 1003147067
Provider Name (Legal Business Name): FAMILIES FIRST MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2908 TAZEWELL PIKE
KNOXVILLE TN
37918-1878
US

IV. Provider business mailing address

2908 TAZEWELL PIKE
KNOXVILLE TN
37918-1878
US

V. Phone/Fax

Practice location:
  • Phone: 865-688-8999
  • Fax: 865-688-8090
Mailing address:
  • Phone: 865-688-8999
  • Fax: 865-688-8090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSANNE NELMS
Title or Position: PRACTICE ADMINISTRATOR/DIRECTOR
Credential:
Phone: 865-549-4892