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General NPI Number Information
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NPI Number | 1801177449
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Entity Type | Organization
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Legal Business Name | MCMINN ORTOPAEDIC CLINIC, PC
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 719 COOK DR STE 110
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City | ATHENS
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State | TN
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Zip | 37303-3495
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Country | US
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Telephone | 423-745-2344
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Fax | 423-745-2314
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Provider Business Mailing Address
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Address Line | PO BOX 688
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City | ATHENS
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State | TN
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Zip | 37371-0688
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Country | US
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Telephone | 423-745-2344
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Fax | 423-745-2314
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID R ROBINS
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Credential | D.O.
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Telephone | 423-745-2344
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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 | DO01701
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License Number State | TN
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