Provider Demographics
NPI:1619028099
Name:ALL ABOUT YOU FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:ALL ABOUT YOU FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:423-307-1468
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37815
Mailing Address - Country:US
Mailing Address - Phone:423-307-1468
Mailing Address - Fax:423-307-1479
Practice Address - Street 1:210 E ECONOMY ROAD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814
Practice Address - Country:US
Practice Address - Phone:423-307-1468
Practice Address - Fax:423-307-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1669493433Medicare UPIN
TN1740207760Medicare UPIN