National Provider Identifier Database

MADISONVILLE PRIMARY CARE GROUP PLLC
Rural Health


Contact Information

MADISONVILLE PRIMARY CARE GROUP PLLC
723 N TENNESSEE AVE
ETOWAH, TN37331-1754
Phone: 423-263-2100
Fax: 423-781-7662
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for MADISONVILLE PRIMARY CARE GROUP PLLC

NPI Number 1780304238
Legal business name
LBN
MADISONVILLE PRIMARY CARE GROUP PLLC
Authorized official GREGORY CAIN - (PA-C, OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/02/2022
Last updated 11/04/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

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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