Provider Demographics
NPI:1477086981
Name:STATCARE INPATIENT LLC
Entity Type:Organization
Organization Name:STATCARE INPATIENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-909-0090
Mailing Address - Street 1:2240 SUTHERLAND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-2333
Mailing Address - Country:US
Mailing Address - Phone:865-909-0090
Mailing Address - Fax:
Practice Address - Street 1:2240 SUTHERLAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2333
Practice Address - Country:US
Practice Address - Phone:865-909-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty