Provider Demographics
NPI:1033447008
Name:FAMILYCARE SPECIALISTS PC
Entity Type:Organization
Organization Name:FAMILYCARE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-584-2146
Mailing Address - Street 1:PO BOX 52268
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-2268
Mailing Address - Country:US
Mailing Address - Phone:865-584-2146
Mailing Address - Fax:865-584-9660
Practice Address - Street 1:1120 E WEISGARBER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2685
Practice Address - Country:US
Practice Address - Phone:865-584-1054
Practice Address - Fax:865-588-8350
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILYCARE SPECIALISTS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty