Organization
HEARTLAND MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT G FUGATE (CREDENTIALING)
(423) 626-7297
Entity
Organization
Contact information
Practice address
309 N BROAD ST, NEW TAZEWELL, TN 37825-6600
(423) 626-7297
(423) 851-4704
Mailing address
309 N BROAD ST, NEW TAZEWELL, TN 37825-6600
(423) 626-7297
(423) 851-4704
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3715984
—
TN
Enumeration date
09/22/2006
Last updated
07/18/2008
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