Mountain Region Family Medicine, Pc

LBN: Mountain Region Family Medicine, Pc
Mountain Region Family Medicine, Pc is an health care organization with primary practice located at 101 Professional Park Pvt Dr , Kingsport TN 37663-2288. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Mountain Region Family Medicine, Pc can be contacted via phone (423) 239-7300, or through Trent, Wanda via phone (423) 230-2109.

Contact Information

Primary practice address
101 Professional Park Pvt Dr Kingsport TN 37663-2288
Phone: (423) 239-7300
Fax: (423) 239-8581
Website:
Map and Directions
Authorized official contact:
Name: Trent, Wanda
Phone: (423) 230-2109

Health care specialties

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

Profile Details

NPI number 1710990601
LBN Legal business name Mountain Region Family Medicine, Pc
DBA Doing business as
Authorized official Trent, Wanda
Entity Organization
Organization subpart 1 No
Enumeration date Aug 14th, 2006
Last updated Dec 14th, 2017 - about 7 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 1710990601 NPPES
Tennessee Other 020189600 FBL
Tennessee MEDICAID 3706159 FBL
Tennessee Other 31378070 FBL

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