Organization
HUMBOLDT PRIMARY CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAYASREE CHANDA MD (DOCTOR)
(901) 475-1260
Entity
Organization
Contact information
Practice address
1830 HIGHWAY 51 S, COVINGTON, TN 38019-3622
(901) 475-1260
(901) 475-1266
Mailing address
1830 HIGHWAY 51 SOUTH, COVINGTON, TN 38019-0000
(901) 475-1260
(901) 475-1266
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MD29888
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3855243
—
TN
Enumeration date
05/03/2007
Last updated
04/01/2008
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