| Mancel Wakham Llc | |
|
1000 Bradford Way Ste 500 Kingston TN 37763-3126 | |
| (865) 621-3601 | |
| (865) 409-5733 |
| Full Name | Mancel Wakham Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Bradford Way Ste 500, Kingston, Tennessee |
| Authorized Official Name and Position | Mancel Wakhem (OWNER) |
| Authorized Official Contact | 8656213601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mancel Wakham Llc 1000 Bradford Way Ste 500 Kingston TN 37763-3126 Ph: (865) 621-3601 | Mancel Wakham Llc 1000 Bradford Way Ste 500 Kingston TN 37763-3126 Ph: (865) 621-3601 |
| NPI Number | 1487475067 |
|---|---|
| Provider Enumeration Date | 10/17/2024 |
| Last Update Date | 10/17/2024 |
| Medicare PECOS PAC ID | 9830627439 |
|---|---|
| Medicare Enrollment ID | O20250109003965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487475067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mancel W Wakham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073568218 PECOS PAC ID: 8527032366 Enrollment ID: I20040830000162 |
| Provider Name | Robert Joseph Ampudia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437127610 PECOS PAC ID: 7618940073 Enrollment ID: I20110614000080 |
| Provider Name | Amanda Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669857850 PECOS PAC ID: 2961703616 Enrollment ID: I20151222001519 |
| Provider Name | Catherine Smelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962087650 PECOS PAC ID: 0941671374 Enrollment ID: I20250212000082 |
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 | |
Robert S. Parker, Iii, O.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 931 W Race St, Ste A, Kingston, TN 37763 Phone: 865-248-8130 | |
Active Family & Sports Chiropractic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 Gallaher Rd, Suite B & C, Kingston, TN 37763 Phone: 865-382-3014 Fax: 865-248-8215 | |
Kingston Family Practice, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 820 W Race St, Kingston, TN 37763 Phone: 865-376-3406 Fax: 865-376-9091 | |
Kingston Urgent Care And Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 N Kentucky St, Kingston, TN 37763 Phone: 865-617-8579 | |
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 |