Organization
WYNN HABERSHAM COMMUNITY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES H. WILKENS M.D. (OWNER)
(423) 784-5110
Entity
Organization
Contact information
Practice address
1037 STINKING CREEK RD, LA FOLLETTE, TN 37766-6108
(423) 784-5110
Mailing address
PO BOX 946, JELLICO, TN 37762-0946
(423) 784-0269
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2007
Last updated
07/16/2007
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