OPTIMUM PRIMARY CARE PC NPI 1952728289

NPI Information

  • NPI: 1952728289
  • Provider Name: OPTIMUM PRIMARY CARE PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 444 CLINCHFIELD ST
    SUITE 303
    KINGSPORT, TN
    ZIP 37660
  • Phone: (423) 914-3195

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NPI Details

OPTIMUM PRIMARY CARE PC is a family medicine in Kingsport, 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. OPTIMUM PRIMARY CARE PC NPI is 1952728289. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

444 CLINCHFIELD ST
SUITE 303
KINGSPORT, TN
ZIP 37660-606
Phone: (423) 914-3195
Fax: (423) 230-2818

The provider's authorized official is Mack Lynn Hicks .
The authorized official title is Physician and has the following contact phone number (423) 914-3195.

The enumeration date for this NPI number is 3/25/2014 and was last updated on 3/25/2014.

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 MedicineMD0000015018TENNESSEEYes

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
13024432MEDICAIDTENNESSEE
2A98887MEDICARE UPINTENNESSEE
33024437MEDICARE PINTENNESSEE

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: 11/21/2025

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