Organization
EASTLAKE MEDICAL, PLLC
Active
Other names
Eastlake Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA MICHELLE MADRON (PRACTICE ADMIN)
(423) 352-6500
Entity
Organization
Contact information
Practice address
2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
(423) 352-6500
Mailing address
2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
(423) 352-6500
(423) 352-6501
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6065731
AETNA
—
05
—
Q028641
—
TN
Enumeration date
02/24/2017
Last updated
05/14/2026
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