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General NPI Number Information
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NPI Number | 1831275825
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Entity Type | Organization
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Legal Business Name | LECONTE FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 300 PRINCE ST
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3823
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Country | US
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Telephone | 865-453-2806
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4310
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City | SEVIERVILLE
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State | TN
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Zip | 37864-4310
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Country | US
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Telephone | 865-453-2806
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Fax |
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MS. LINDA DIANA CARTER
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Credential | R.N.
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Telephone | 865-453-2806
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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 | MD30020
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License Number State | TN
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