| Restoration Clinic | |
|
16850 State Highway 58 South Suite A Decatur TN 37322 | |
| (423) 506-3781 | |
| (423) 454-0125 |
| Full Name | Restoration Clinic |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 16850 State Highway 58 South, Decatur, Tennessee |
| Authorized Official Name and Position | English Paige Roberts (OWNER) |
| Authorized Official Contact | 4233342300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Clinic 16850 State Highway 58 S Ste A Decatur TN 37322-5259 Ph: (423) 507-7961 | Restoration Clinic 16850 State Highway 58 South Suite A Decatur TN 37322 Ph: (423) 506-3781 |
| NPI Number | 1174226757 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 02/06/2024 |
| Medicare PECOS PAC ID | 1456577451 |
|---|---|
| Medicare Enrollment ID | O20231227002371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174226757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
R. Shane Roberts, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 398 N Main St, Decatur, TN 37322 Phone: 423-334-2222 Fax: 423-334-2255 | |
R. Shane Roberts, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 398 N Main St, Decatur, TN 37322 Phone: 423-334-2222 Fax: 423-334-2255 | |
Ocoee Regional Health Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 305 River Rd, Decatur, TN 37322 Phone: 423-334-4154 Fax: 423-334-4195 |