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General NPI Number Information
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NPI Number | 1083944177
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Entity Type | Organization
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Legal Business Name | SCOTT COUNTY PRIMARY CARE
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 20445 ALBERTA ST
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City | ONEIDA
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State | TN
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Zip | 37841-3509
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Country | US
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Telephone | 423-569-6396
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Fax |
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Provider Business Mailing Address
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Address Line | 20445 ALBERTA ST
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City | ONEIDA
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State | TN
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Zip | 37841-3509
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Country | US
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Telephone | 423-569-6396
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/DIRECTOR
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Name | SUSANNE NELMS
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Credential |
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Telephone | 865-549-4892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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