Organization
THOMAS W. CONWAY
Active
Other names
Primary Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE MCCOLLUM (PRACTICE MANAGER)
(423) 623-0640
Entity
Organization
Contact information
Practice address
434 4TH ST, SUITE 310, NEWPORT, TN 37821-3746
(423) 623-0640
(423) 623-7615
Mailing address
434 4TH ST, SUITE 310, NEWPORT, TN 37821-3746
(423) 623-0640
(423) 623-7615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16692
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3718054
MEDICARE GROUP ID
—
05
—
3718054
—
TN
Enumeration date
01/30/2006
Last updated
05/18/2010
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