Organization
FIRST MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA KAY MORRIS (OFFICE MANAGER)
(423) 543-1261
Entity
Organization
Contact information
Practice address
1505 W ELK AVE, STE 2, ELIZABETHTON, TN 37643-2848
(423) 543-1261
(423) 543-7500
Mailing address
1505 W ELK AVE, STE 2, ELIZABETHTON, TN 37643-2848
(423) 543-1261
(423) 543-7500
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MD0000007688
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201575
JERRY L. GASTINEAU
TN
01
—
201576
ROBERT E. WALTER
TN
01
—
202731
DAVID K. FENNER
TN
01
—
3049825
CHRISTOPHER CHRISOHON
TN
01
—
3095880
TODD A WHITAKER
TN
Enumeration date
06/17/2006
Last updated
08/22/2020
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