| Clinchfield Family Medicine, Pllc | |
|
2204 Pavilion Dr Suite 110 Kingsport TN 37660-4657 | |
| (423) 378-1500 | |
| (423) 378-1520 |
| Full Name | Clinchfield Family Medicine, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2204 Pavilion Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | Holly Charlene Grigsby (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 4233781500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinchfield Family Medicine, Pllc 2204 Pavilion Dr Suite 110 Kingsport TN 37660-4657 Ph: (423) 378-1500 | Clinchfield Family Medicine, Pllc 2204 Pavilion Dr Suite 110 Kingsport TN 37660-4657 Ph: (423) 378-1500 |
| NPI Number | 1316228075 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 10/28/2013 |
| Medicare PECOS PAC ID | 2062689193 |
|---|---|
| Medicare Enrollment ID | O20120112000762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316228075 | NPI | - | NPPES |
| 1527171 | Medicaid | TN | |
| 1316228075 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0000042820 (Tennessee) | Primary |
| Provider Name | Holly C Grigsby |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326138470 PECOS PAC ID: 1355423773 Enrollment ID: I20080124000256 |
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Carl E Bendeck Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1328 Belmeade Dr, Kingsport, TN 37664 Phone: 423-578-3489 | |
A. Evan Lewis Phd Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1936 Brookside Dr Ste D, Kingsport, TN 37660 Phone: 423-392-5020 Fax: 423-392-5100 |