# TAKOMA REGIONAL HOSPITAL DBA TAKOMA MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Takoma Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720105810
- **Authorized official:** TODD J DOUGAN (CFO)
- **Authorized official phone:** (423) 230-8512

## Contact information

- **Practice address:** 401 TAKOMA AVE, GREENEVILLE, TN 37743-4647
- **Practice address phone:** (423) 636-3151
- **Mailing address:** PO BOX 37087, BALTIMORE, MD 21297-3807
- **Mailing address phone:** (423) 224-3250
- **Mailing address fax:** (423) 224-3258

## Taxonomy

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

## Other

- **Enumeration date:** 03/23/2007
- **Last updated:** 02/06/2017