| Psychiatric Care Of Kingsport Pc | |
|
444 Clinchfield St Ste 101 Kingsport TN 37660-3859 | |
| (423) 392-6502 | |
| (423) 392-6504 |
| Full Name | Psychiatric Care Of Kingsport Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 444 Clinchfield St Ste 101, Kingsport, Tennessee |
| Authorized Official Name and Position | Judy R Wampler (OFFICE MANAGER) |
| Authorized Official Contact | 4233926502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Care Of Kingsport Pc 444 Clinchfield St Ste 101 Kingsport TN 37660-3859 Ph: (423) 392-6502 | Psychiatric Care Of Kingsport Pc 444 Clinchfield St Ste 101 Kingsport TN 37660-3859 Ph: (423) 392-6502 |
| NPI Number | 1326732793 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Medicare PECOS PAC ID | 8921461013 |
|---|---|
| Medicare Enrollment ID | O20230822002838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326732793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Eric Moffet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609984178 PECOS PAC ID: 6406039916 Enrollment ID: I20111118000158 |
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