Organization
OMNI PRIMARY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY FORD (SECREATARY)
(423) 755-5557
Entity
Organization
Contact information
Practice address
1000 E 3RD ST, #300, CHATTANOOGA, TN 37403-2106
(423) 778-8021
Mailing address
975 E 3RD ST, EMC #330, CHATTANOOGA, TN 37403-2147
(423) 778-8021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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