| Vital Care Clinic Of Estill Springs | |
|
300 S Main St # A Estill Springs TN 37330-4042 | |
| (615) 612-9397 | |
| Not Available |
| Full Name | Vital Care Clinic Of Estill Springs |
|---|---|
| Speciality | Family Medicine |
| Location | 300 S Main St # A, Estill Springs, Tennessee |
| Authorized Official Name and Position | Amber Nicole Wooten (OWNER/PROVIDER) |
| Authorized Official Contact | 6156129397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Care Clinic Of Estill Springs Po Box 85 Estill Springs TN 37330-0085 Ph: (615) 612-9397 | Vital Care Clinic Of Estill Springs 300 S Main St # A Estill Springs TN 37330-4042 Ph: (615) 612-9397 |
| NPI Number | 1427829696 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 0446794663 |
|---|---|
| Medicare Enrollment ID | O20240628002248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427829696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Muhamed Faour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982672507 PECOS PAC ID: 1850319948 Enrollment ID: I20051107001156 |
| Provider Name | Amber N Wooten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346010030 PECOS PAC ID: 9234673450 Enrollment ID: I20240628002383 |
Amg-southern Tennessee Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Main St, Estill Springs, TN 37330 Phone: 931-649-5139 Fax: 931-649-2766 |