Organization
HCC OF JELLICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON WEISS (CEO)
(972) 934-3200
Entity
Organization
Contact information
Practice address
188 HOSPITAL LN, JELLICO, TN 37762-4400
(423) 784-7252
Mailing address
17304 PRESTON RD, DALLAS, TX 75252-5618
(972) 934-3200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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