MEDICARE: UHS PRIMARY CARE LLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1770381196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UHS PRIMARY CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 415000-MSC8552
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37241-8552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5779 CREEKWOOD PARK BLVD STE 220
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-1203
Country	:	US
Telephone Number	:	865-988-6330
Fax Number	:	865-988-8772

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BETH MAYNARD
Credential	:
Telephone Number	:	865-585-8986

Provider Enumeration Date	:	03/03/2025
Last Update Date	:	03/03/2025

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Directions to “UHS PRIMARY CARE LLC ” Practice Location

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