# CLASS 'A' CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLASS 'A' CLINIC LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073095154
- **Authorized official:** CHARLENE CROWDER MATTHEWS APN-BC (PRACTITIONER)
- **Authorized official phone:** (423) 720-9111

## Contact information

- **Practice address:** 833 W HIGHWAY 25 70 STE D, NEWPORT, TN 37821-8045
- **Practice address phone:** (423) 720-9111
- **Practice address fax:** (423) 301-5756
- **Mailing address:** 833 W HIGHWAY 25 70 STE D, NEWPORT, TN 37821-8045
- **Mailing address phone:** (423) 720-9111
- **Mailing address fax:** (423) 301-5756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 16835 | TN | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/05/2018
- **Last updated:** 06/06/2025