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NPI Code Detail

MEDICARE: FAMILY PRACTICE OF CORRYTON

MEDICARE: FAMILY PRACTICE OF CORRYTON
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1245752997
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRACTICE OF CORRYTON
Provider Business Mailing Address
First Line : PO BOX 88
Second Line :
City : CORRYTON
State : TN
Zip : 37721-0088
Country : US
Telephone Number : 865-992-3031
Fax Number : 865-992-8103
Provider Business Practice Location Address
First Line : 7701 CORRYTON RD
Second Line :
City : CORRYTON
State : TN
Zip : 37721-2630
Country : US
Telephone Number : 865-247-6263
Fax Number : 865-992-8103
Authorized Official
Title or Position : OFFICE MANAGER
Name : KIM M DAUGHERTY
Credential :
Telephone Number : 865-992-3031
Provider Enumeration Date : 07/14/2017
Last Update Date : 07/14/2017

Similar Medicare Providers

1457470015 — MRS. KAREN PHILLIPS BEETS F.N.P.
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1134489024 — BRADEN FAMILY MEDICINE, PLLC
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1386028488 — JORDAN L DYER FNP
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1922544170 — FARMER PRACTICE LLC
Practice Location Address:
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1255339081 — DR. KALPESH D PARIKH M.D.
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Directions to “FAMILY PRACTICE OF CORRYTON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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