Optimum Primary Care Pc

LBN: Optimum Primary Care Pc
Optimum Primary Care Pc is an health care organization with primary practice located at 444 Clinchfield St Suite 303, Kingsport TN 37660-3606. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Optimum Primary Care Pc can be contacted via phone (423) 914-3195, or through Hicks, Mack Lynn via phone (423) 914-3195.

Contact Information

Primary practice address
444 Clinchfield St Suite 303 Kingsport TN 37660-3606
Phone: (423) 914-3195
Fax: (423) 230-2818
Website:
Map and Directions
Authorized official contact:
Name: Hicks, Mack Lynn Doctor of Medicine (MD)
Phone: (423) 914-3195

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD0000015018 Tennessee

Profile Details

NPI number 1952728289
LBN Legal business name Optimum Primary Care Pc
DBA Doing business as
Authorized official Hicks, Mack Lynn Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 25th, 2014
Last updated Mar 25th, 2014 - about 11 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 1952728289 NPPES
Tennessee MEDICAID 3024432

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