# MADISONVILLE PRIMARY CARE GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** United Primary Care Etowah
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780304238
- **Authorized official:** GREGORY BRIAN CAIN (PA-C, OWNER)
- **Authorized official phone:** (423) 442-2121

## Contact information

- **Practice address:** 723 N TENNESSEE AVE, ETOWAH, TN 37331-1754
- **Practice address phone:** (423) 263-2100
- **Practice address fax:** (423) 781-7662
- **Mailing address:** PO BOX 808, KINGSTON, TN 37763-0808
- **Mailing address phone:** (865) 224-7172
- **Mailing address fax:** (865) 224-7171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2022
- **Last updated:** 11/04/2024