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General NPI Number Information
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NPI Number | 1225141492
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Entity Type | Organization
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Legal Business Name | ULTACARE MEDICAL PLLC
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 849 LAKESHORE DR
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City | DANDRIDGE
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State | TN
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Zip | 37725
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Country | US
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Telephone | 423-736-0264
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Fax |
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Provider Business Mailing Address
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Address Line | 7951 E MAPLEWOOD AVE STE 118
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4724
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Country | US
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Telephone | 720-638-0846
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | ERIC F HASEMEIER
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Credential | DO
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Telephone | 865-365-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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