| Kingston Family Practice, P.c. | |
|
820 W Race St Kingston TN 37763-2120 | |
| (865) 376-3406 | |
| (865) 376-9091 |
| Full Name | Kingston Family Practice, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 820 W Race St, Kingston, Tennessee |
| Authorized Official Name and Position | Dwight H Willett (PRESIDENT) |
| Authorized Official Contact | 8653763406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingston Family Practice, P.c. 820 W Race St Kingston TN 37763-2120 Ph: (865) 376-3406 | Kingston Family Practice, P.c. 820 W Race St Kingston TN 37763-2120 Ph: (865) 376-3406 |
| NPI Number | 1356432041 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 05/10/2023 |
| Medicare PECOS PAC ID | 5294734182 |
|---|---|
| Medicare Enrollment ID | O20070611000731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356432041 | NPI | - | NPPES |
| 080080789 | Other | TN | RAILROAD MEDICARE |
| 080153049 | Other | TN | RAILROAD MEDICARE |
| 443961 | Other | TN | RIVERBEND MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | Dwight H Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598746554 PECOS PAC ID: 8022076157 Enrollment ID: I20041221000778 |
Elite Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 N 3rd St, Kingston, TN 37763 Phone: 865-224-6513 Fax: 865-245-4546 | |
Parker Family Eyecare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 931 W Race St, Ste A, Kingston, TN 37763 Phone: 865-248-8130 | |
Summit Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 933 W Race St, Kingston, TN 37763 Phone: 865-882-0105 | |
Kingston Health Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 N Kentucky St, Kingston, TN 37763 Phone: 865-717-1121 Fax: 865-717-1167 |