PHYSICIAN FIRST PC NPI 1629108691

NPI Information

  • NPI: 1629108691
  • Provider Name: PHYSICIAN FIRST PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D2314872
  • Address: 2725 KEITH ST NW
    CLEVELAND, TN
    ZIP 37312
  • Phone: (423) 476-3330

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NPI Details

PHYSICIAN FIRST PC is a family medicine in Cleveland, 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. PHYSICIAN FIRST PC NPI is 1629108691. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2725 KEITH ST NW
CLEVELAND, TN
ZIP 37312
Phone: (423) 476-3330
Fax: (423) 476-5802

The provider's authorized official is Gerard K Mazza .
The authorized official title is Supervising and has the following contact phone number (423) 476-3330.

The CLIA number assigned to this NPI record is 11D2314872 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 10/3/2024.

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
1207Q00000XFamily MedicineMD015727TENNESSEEYes
2363A00000XPhysician AssistantPA0000000148TENNESSEENo

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
13841466MEDICAIDTENNESSEE
24009361OTHERTENNESSEEBCBS

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: 3/30/2025

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