Organization
MEDICAL CENTER CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASHA LASHEA' BUSSELL (PRESIDENT/OWNER)
(423) 259-5850
Entity
Organization
Contact information
Practice address
409 CAWOOD RD, TAZEWELL, TN 37879-3026
(423) 259-5850
(423) 259-5853
Mailing address
409 CAWOOD RD, TAZEWELL, TN 37879-3026
(423) 259-5850
(423) 259-5853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/07/2006
Last updated
10/18/2018
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