Organization Name: | FIRST MED INC |
NPI Number: | 1952719601 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT M MAUGHON (OWNER) |
Mailing Address: | 190 Community Center Dr Suite 102 Pigeon Forge |
State: | TN US |
Postal Code: | 378636251 |
Phone Number: | 8654464032 |
Fax Number: | 8658684746 |
NPI Enumeration Date: | 07/25/2014 |
NPI Last Update Date: | 07/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | MD16795 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |