| Organization Name: | UCSC PRIMARY CARE |
| NPI Number: | 1497037451 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JON PATRICK DOWNEY (MEDICAL DIRECTOR) |
| Mailing Address: | 598 John Deere Dr Maynardville |
| State: | TN US |
| Postal Code: | 378073212 |
| Phone Number: | 8659926060 |
| Fax Number: | 8659927060 |
| NPI Enumeration Date: | 09/15/2011 |
| NPI Last Update Date: | 09/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 15988 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |