| Englewood Family Practice | |
|
135 North Meadow Drive Ste #a Athens TN 37303 | |
| (423) 745-9715 | |
| (423) 745-2440 |
| Full Name | Englewood Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 135 North Meadow Drive, Athens, Tennessee |
| Authorized Official Name and Position | Barbara A Chambers (OFFICE MANAGER) |
| Authorized Official Contact | 4237459715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Englewood Family Practice 135 North Meadow Drive Ste #a Athens TN 37303 Ph: (423) 745-9715 | Englewood Family Practice 135 North Meadow Drive Ste #a Athens TN 37303 Ph: (423) 745-9715 |
| NPI Number | 1033317144 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 07/25/2023 |
| Medicare PECOS PAC ID | 9133186885 |
|---|---|
| Medicare Enrollment ID | O20041214000574 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033317144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 19400 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | MD19400 (Tennessee) | Primary |
| Provider Name | Alicia D Durham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629301312 PECOS PAC ID: 3678616513 Enrollment ID: I20100201000570 |
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