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General NPI Number Information
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NPI Number | 1417360751
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Entity Type | Organization
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Legal Business Name | E.E. MEDICAL CONSULTANTS
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 150 LONG RD
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City | KINGSTON
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State | TN
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Zip | 37763-5316
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Country | US
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Telephone | 865-399-2681
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Fax |
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Provider Business Mailing Address
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Address Line | 150 LONG RD
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City | KINGSTON
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State | TN
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Zip | 37763-5316
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Country | US
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Telephone | 865-399-2681
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PATRECIA E EATON
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Credential | P.A.
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Telephone | 865-399-2681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 39250
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1137
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 39250
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License Number State | TN
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