| Dr Kenneth W Patric Jr, MD | |
|
403 Mcbrien Rd, East Ridge, TN 37412-3223 | |
| (423) 875-0700 | |
| Not Available |
| Full Name | Dr Kenneth W Patric Jr |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 403 Mcbrien Rd, East Ridge, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366480014 | NPI | - | NPPES |
| 69243 | Other | GA | GEORGIA MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 69243 (Georgia) | Secondary |
| 207Q00000X | Family Medicine | MD0000027485 (Tennessee) | Primary |
| Entity Name | The Little Clinic Of Tennessee Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487848800 PECOS PAC ID: 4688762800 Enrollment ID: O20080326000339 |
| Entity Name | Crossroads Urgent Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366644361 PECOS PAC ID: 8325117484 Enrollment ID: O20080515000672 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kenneth W Patric Jr, MD 2485 Baskette Way, Chattanooga, TN 37421-7615 Ph: (423) 240-4829 | Dr Kenneth W Patric Jr, MD 403 Mcbrien Rd, East Ridge, TN 37412-3223 Ph: (423) 875-0700 |
Dr. Randy Robert Heisser, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1508 Tombras Ave, East Ridge, TN 37412 Phone: 423-867-4969 Fax: 423-867-4971 | |
Dr. Bruce Allen Pendley, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1508 Tombras Ave, East Ridge, TN 37412 Phone: 423-867-4969 Fax: 423-867-4971 |