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General NPI Number Information
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NPI Number | 1750616207
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Entity Type | Organization
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Legal Business Name | AFFORDABLE HEALTHCARE MEDICAL CLINIC
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 213 FORKS OF THE RIVER PKWY STE 1
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3468
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Country | US
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Telephone | 865-908-2838
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Fax | 865-908-6179
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Provider Business Mailing Address
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Address Line | 213 FORKS OF THE RIVER PKWY STE 1
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3468
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Country | US
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Telephone | 865-908-2838
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Fax | 865-908-6179
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD NED WECKESSER II
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Credential | MD
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Telephone | 865-908-2838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 28080
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 28080
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License Number State | TN
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