| State Of Tennessee | |
|
1362 N Gateway Ave Rockwood TN 37854-4108 | |
| (865) 354-1220 | |
| (865) 354-0112 |
| Full Name | State Of Tennessee |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 1362 N Gateway Ave, Rockwood, Tennessee |
| Authorized Official Name and Position | Marianne F Sharp (REGIONAL ACCOUNTANT) |
| Authorized Official Contact | 8655495266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Tennessee Po Box 59019 Knoxville TN 37950-9019 Ph: (865) 549-5266 | State Of Tennessee 1362 N Gateway Ave Rockwood TN 37854-4108 Ph: (865) 354-1220 |
| NPI Number | 1437203809 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 11/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437203809 | NPI | - | NPPES |
| 2008151 | Other | TN | BLUECROSS BLUESHIELD |
| 4447825 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
Fast Pace Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1118 N Gateway Ave, Rockwood, TN 37854 Phone: 865-444-4345 Fax: 865-444-4346 | |
Summit Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 North Gateway Ave, Rockwood, TN 37854 Phone: 865-354-7799 Fax: 865-354-7797 |