Organization Name: | FIRST MED INC |
NPI Number: | 1942628854 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT M MAUGHON (OWNER) |
Mailing Address: | 3342 Parkway Pigeon Forge |
State: | TN US |
Postal Code: | 378633423 |
Phone Number: | 8654464032 |
Fax Number: | 8658684746 |
NPI Enumeration Date: | 03/29/2014 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 8475 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |