Organization
CCD MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID R KRAGEL PHARMD (OWNER/AUTHORIZED OFFICIAL)
(423) 586-6263
Entity
Organization
Contact information
Practice address
228 N FAIRMONT AVE, MORRISTOWN, TN 37814-3768
(423) 586-6263
Mailing address
228 N FAIRMONT AVE, MORRISTOWN, TN 37814-3768
(423) 586-6263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
09/22/2022
Last updated
05/22/2024
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