National Provider Identifier Database

EASTLAKE URGENT CARE EASTLAKE MEDICAL LLC
Rural Health


Contact Information

EASTLAKE URGENT CARE
LBN EASTLAKE MEDICAL, LLC
2500 JACKSBORO PIKE, SUITE 6
JACKSBORO, TN37766
Phone: 423-352-6500
Fax: 423-352-6501
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Urgent Care 261QU0200X

* Indicates primary specialty

NPI Profile & details for EASTLAKE URGENT CARE

NPI Number 1467992446
Legal business name
LBN
EASTLAKE MEDICAL, LLC
Doing business as
DBA
EASTLAKE URGENT CARE
Authorized official PAULA MADRON - (PRACTICE ADMIN)
Entity Organization
Organization subpart No
Enumeration date 02/24/2017
Last updated 05/14/2026 - About a month ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: Q028641
  • Other: 6065731 AETNA

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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