National Provider Identifier Database

UNICOI COUNTY FAMILY PRACTICE
Primary Care


Contact Information

UNICOI COUNTY FAMILY PRACTICE
108 GAY STREET
ERWIN, TN37650
Phone: 423-743-8400
Fax: 423-743-6888
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for UNICOI COUNTY FAMILY PRACTICE

NPI Number 1407940067
Legal business name
LBN
UNICOI COUNTY FAMILY PRACTICE
Authorized official DIANE CAMPBELL - (PRESIDENT OF CORPORATION)
Entity Organization
Organization subpart No
Enumeration date 10/03/2006
Last updated 07/17/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 25069
  • TN Medicaid: 4004557

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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