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General NPI Number Information
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NPI Number | 1538220496
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Entity Type | Organization
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Legal Business Name | COMMON ILLNESS CLINIC LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 2010 SPRING PLACE RD SE
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City | CLEVELAND
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State | TN
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Zip | 37323-3337
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Country | US
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Telephone | 423-614-4780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3240
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City | CLEVELAND
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State | TN
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Zip | 37320-3240
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Country | US
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Telephone | 423-476-7947
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BRIAN G SCOGGINS
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Credential |
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Telephone | 423-322-4553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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