Organization
FIRST CARE FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM YOUNG APRN (OWNER)
(423) 486-9455
Entity
Organization
Contact information
Practice address
14821 DAYTON PIKE, SUITE B, SALE CREEK, TN 37373
(423) 486-9455
(423) 486-9458
Mailing address
14821 DAYTON PIKE, PO BOX 698, SUITE B, SALE CREEK, TN 37373
(423) 486-9455
(423) 486-9458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
004944
TN
363L00000X
Nurse Practitioner
AP16874
TN
363L00000X
Nurse Practitioner
APN0000005828
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
03/13/2013
Last updated
03/19/2013
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