| Organization Name: | UNICOI COUNTY FAMILY PRACTICE |
| NPI Number: | 1407940067 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE COLE CAMPBELL (PRESIDENT OF CORPORATION) |
| Mailing Address: | 108 Gay Street Erwin |
| State: | TN US |
| Postal Code: | 37650 |
| Phone Number: | 4237438400 |
| Fax Number: | 4237436888 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 25069 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |