EAST TENNESSEE PRIMARY CARE INC NPI 1184801631

NPI Information

NPI: 1184801631
Provider Name: EAST TENNESSEE PRIMARY CARE, INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 44D1041243

Address:
3300 WILCOX BLVD.
CHATTANOOGA, TN
ZIP 37411
Phone: (423) 803-9180
Get Directions

EAST TENNESSEE PRIMARY CARE, INC is a family medicine in Chattanooga, TN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EAST TENNESSEE PRIMARY CARE, INC NPI is 1184801631. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3300 WILCOX BLVD.
CHATTANOOGA, TN
ZIP 37411
Phone: (423) 803-9180
Fax: (423) 803-9181

The provider's authorized official is Winnifred Dunbar-davies .
The authorized official title is Medical Doctor/owner and has the following contact phone number (423) 778-5584.

The CLIA number assigned to this NPI record is 44D1041243 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/28/2008 and was last updated on 1/11/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		27162	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3730348	MEDICARE PIN	TENNESSEE
2	44104835	OTHER	TENNESSEE	TENNCARE SELECT
3	4104835	OTHER	TENNESSEE	BLUE CROSS OF TENNESSEE
4	5487562	OTHER	TENNESSEE	CIGNA
5	F94312	MEDICARE UPIN	TENNESSEE
6	TN0101	OTHER	TENNESSEE	UHC OF THE RIVER VALLEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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