# EASTLAKE MEDICAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastlake Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467992446
- **Authorized official:** PAULA MICHELLE MADRON (PRACTICE ADMIN)
- **Authorized official phone:** (423) 352-6500

## Contact information

- **Practice address:** 2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
- **Practice address phone:** (423) 352-6500
- **Mailing address:** 2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
- **Mailing address phone:** (423) 352-6500
- **Mailing address fax:** (423) 352-6501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | TN | — |

## Other

- **Enumeration date:** 02/24/2017
- **Last updated:** 05/14/2026