| Family Medical Providers, Pllc | |
|
3496 Brainerd Rd Chattanooga TN 37411-3532 | |
| (423) 243-8196 | |
| Not Available |
| Full Name | Family Medical Providers, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3496 Brainerd Rd, Chattanooga, Tennessee |
| Authorized Official Name and Position | Paul Anthony Miranda (OWNER) |
| Authorized Official Contact | 4232438196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Providers, Pllc Po Box 93 Signal Mountain TN 37377-0093 Ph: (423) 243-8196 | Family Medical Providers, Pllc 3496 Brainerd Rd Chattanooga TN 37411-3532 Ph: (423) 243-8196 |
| NPI Number | 1871140475 |
|---|---|
| Provider Enumeration Date | 08/20/2019 |
| Last Update Date | 03/13/2020 |
| Medicare PECOS PAC ID | 5991137978 |
|---|---|
| Medicare Enrollment ID | O20191112003472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871140475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ann S Geraci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558509760 PECOS PAC ID: 1254484447 Enrollment ID: I20090805000747 |
| Provider Name | Jonathan Ryan Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861091266 PECOS PAC ID: 6103236732 Enrollment ID: I20201110000881 |
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