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Organization
PHYSICIAN FIRST PC
Active
Organization
PHYSICIAN FIRST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERARD K MAZZA MD (SUPERVISING)
(423) 476-3330
Entity
Organization
Contact information
Practice address
2725 KEITH ST NW, CLEVELAND, TN 37312
(423) 476-3330
(423) 476-5802
Mailing address
2725 KEITH ST NW, CLEVELAND, TN 37312
(423) 476-3330
(423) 476-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD015727
TN
363A00000X
Physician Assistant
PA0000000148
TN
Other
Enumeration date
03/07/2007
Last updated
10/03/2024
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