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General NPI Number Information
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NPI Number | 1285838177
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Entity Type | Organization
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Legal Business Name | OAK RIDGE MEDICAL CLINIC, P.C.
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 170 WEST TENNESSEE AVENUE
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City | OAK RIDGE
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State | TN
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Zip | 37830
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Country | US
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Telephone | 865-483-7411
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Fax | 865-483-7413
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Provider Business Mailing Address
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Address Line | 170 WEST TENNESSEE AVENUE
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City | OAK RIDGE
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State | TN
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Zip | 37830
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Country | US
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Telephone | 865-483-7411
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Fax | 865-483-7413
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. HELEN A. VODOPICK-GOSWITZ
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Credential | M.D.
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Telephone | 865-483-7411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD5413
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License Number State | TN
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