Provider Demographics
NPI:1467968859
Name:OUTREACH CLINICS UNLIMITED PLLC
Entity Type:Organization
Organization Name:OUTREACH CLINICS UNLIMITED PLLC
Other - Org Name:PH7 DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-724-3168
Mailing Address - Street 1:1627 OLD GRAY STATION RD STE 4
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4193
Mailing Address - Country:US
Mailing Address - Phone:423-282-3376
Mailing Address - Fax:
Practice Address - Street 1:1627 OLD GRAY STATION RD STE 4
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-4193
Practice Address - Country:US
Practice Address - Phone:423-282-3376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty