Healthcare Provider Details

I. General information

NPI: 1033282405
Provider Name (Legal Business Name): SCOTT COUNTY MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19268 ALBERTA AVE
ONEIDA TN
37841
US

IV. Provider business mailing address

PO BOX 5420
ONEIDA TN
37841
US

V. Phone/Fax

Practice location:
  • Phone: 423-569-8462
  • Fax: 423-569-2577
Mailing address:
  • Phone: 423-569-8462
  • Fax: 423-569-2577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number0270796
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number0270796
License Number StateTN

VIII. Authorized Official

Name: MRS. TRACY K MORGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 423-569-8462