| Mancel Wakham, Do Pc | |
|
2497 S Roane St Suite 110 Harriman TN 37748 | |
| (865) 590-0889 | |
| (865) 590-0884 |
| Full Name | Mancel Wakham, Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2497 S Roane St, Harriman, Tennessee |
| Authorized Official Name and Position | Lisa Packett (MANAGER) |
| Authorized Official Contact | 8653210048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mancel Wakham, Do Pc 2497 S Roane St Suite 110 Harriman TN 37748 Ph: (865) 230-5698 | Mancel Wakham, Do Pc 2497 S Roane St Suite 110 Harriman TN 37748 Ph: (865) 590-0889 |
| NPI Number | 1497952600 |
|---|---|
| Provider Enumeration Date | 06/29/2007 |
| Last Update Date | 07/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497952600 | NPI | - | NPPES |
| 3725874 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D00000000982 (Tennessee) | Primary |
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