Organization
1 TEAM CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES CALVIN DOTY JR. (PRESIDENT)
(423) 639-0187
Entity
Organization
Contact information
Practice address
199 POTTERTOWN RD, MIDWAY, TN 37809-3213
(423) 422-4454
Mailing address
PO BOX 416, GREENEVILLE, TN 37744-0416
(423) 639-0187
(423) 639-2504
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1043217352
TN
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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