Healthcare Provider Details

I. General information

NPI: 1376607051
Provider Name (Legal Business Name): MMC HEALTHWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 OAK RIDGE TPKE PHYSICIANS PLAZA SUITE L-50
OAK RIDGE TN
37830-6930
US

IV. Provider business mailing address

988 OAK RIDGE TPKE PHYSICIANS PLAZA SUITE L-50
OAK RIDGE TN
37830-6930
US

V. Phone/Fax

Practice location:
  • Phone: 865-481-5413
  • Fax:
Mailing address:
  • Phone: 865-481-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAN MCNALLY
Title or Position: ADMINISTRATION
Credential:
Phone: 865-481-1101