Organization
PRIMARY CARE AND GERIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGULA GUPTA (OFFICE MANAGER)
(423) 317-7412
Entity
Organization
Contact information
Practice address
711 MCFARLAND ST, MORRISTOWN, TN 37814
(423) 317-7412
(423) 317-7415
Mailing address
711 MCFARLAND ST, MORRISTOWN, TN 37814-3977
(423) 317-7412
(423) 317-7415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080190473
RAILROAD MEDICARE
TN
05
—
3372546
—
TN
Enumeration date
06/14/2007
Last updated
08/31/2015
Update your record
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