# COLLEGE PARK WALK-IN CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174602338
- **Authorized official:** BETH D YOUNG (OFFICE MANAGER)
- **Authorized official phone:** (423) 318-6093

## Contact information

- **Practice address:** 2104 E ANDREW JOHNSON HWY, MORRISTOWN, TN 37814-5412
- **Practice address phone:** (423) 318-6093
- **Practice address fax:** (423) 318-6297
- **Mailing address:** PO BOX 1237, MORRISTOWN, TN 37816-1237
- **Mailing address phone:** (423) 318-6093
- **Mailing address fax:** (423) 318-6297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 09/27/2007