Organization
PHYSICIAN ASSOCIATE RESOURCES, PLC
Active
Other names
Clinica Familiar Latinoamerica
Organization subpart
No
Provider details
NPI number
Authorized official
RUDY GARY HAMM PA-C (PROVIDER)
(865) 635-8389
Entity
Organization
Contact information
Practice address
1559 HIGHLAND PARK DRIVE, LENOIR CITY, TN 37772
(865) 748-5057
(865) 635-8390
Mailing address
1559 HIGHLAND PARK DR, LENOIR CITY, TN 37772-6237
(865) 635-8389
(865) 635-8390
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3669684
—
TN
01
—
PA0000000203
STATE OF TN
TN
Enumeration date
03/26/2019
Last updated
12/20/2019
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