Organization
ATTENTUS OF SCOTT COUNTY, LLC
Active
Other names
Scott County Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M. CROSS (BOM)
(423) 569-8521
Entity
Organization
Contact information
Practice address
20445 ALBERTA ST, ONEIDA, TN 37841-3509
(423) 569-6396
(423) 569-8640
Mailing address
PO BOX 4609, ONEIDA, TN 37841-4609
(423) 569-7918
(423) 569-8640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
357349
ANTHEM BCBS GROUP #
KY
05
—
3728761
—
TN
05
—
78904331
—
KY
01
—
DC7935
MEDICARE RAILROAD
—
Enumeration date
03/29/2006
Last updated
03/10/2008
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