Organization
LAFOLLETTE HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY CHILDS (OFFICE MANAGER)
(423) 566-6466
Entity
Organization
Contact information
Practice address
2503 JACKSBORO PIKE, JACKSBORO, TN 37757-4847
(423) 566-6466
(423) 566-1387
Mailing address
2503 JACKSBORO PIKE, JAKCSBORO, TN 37757
(423) 566-6466
(423) 566-1387
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26889
TN
207R00000X
Internal Medicine Physician
27551
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407031271
NPI
TN
01
—
1619908597
NPI
TN
01
—
1811928799
NPI
TN
Enumeration date
12/29/2007
Last updated
05/17/2011
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