MEDICARE: PHYSICIAN ONSITE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician
2	207R00000X	Internal Medicine Physician
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1174897888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN ONSITE, INC

Provider Business Mailing Address
First Line	:	3570 KEITH ST NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-4309
Country	:	US
Telephone Number	:	423-473-5026
Fax Number	:

Provider Business Practice Location Address
First Line	:	3570 KEITH ST NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-4309
Country	:	US
Telephone Number	:	423-473-5026
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/ ASSISTANT SECRETARY
Name	:	CINDY S CROSS
Credential	:
Telephone Number	:	423-473-5867

Provider Enumeration Date	:	02/27/2012
Last Update Date	:	09/15/2021

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