Mancel Wakham, Do Pc

LBN: Mancel Wakham, Do Pc
Mancel Wakham, Do Pc is an health care organization with primary practice located at 2497 S Roane St Suite 110, Harriman TN 37748. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Mancel Wakham, Do Pc can be contacted via phone (865) 590-0889, or through Packett, Lisa via phone (865) 321-0048.

Contact Information

Primary practice address
2497 S Roane St Suite 110 Harriman TN 37748
Phone: (865) 590-0889
Fax: (865) 590-0884
Website:
Map and Directions
Authorized official contact:
Name: Packett, Lisa
Phone: (865) 321-0048

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D00000000982 Tennessee

Profile Details

NPI number 1497952600
LBN Legal business name Mancel Wakham, Do Pc
DBA Doing business as
Authorized official Packett, Lisa
Entity Organization
Organization subpart 1 No
Enumeration date Jun 29th, 2007
Last updated Jul 24th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497952600 NPPES
Tennessee MEDICAID 3725874

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