Provider Demographics
NPI:1689877607
Name:PHYSICIANS CLINIC, P.C.
Entity Type:Organization
Organization Name:PHYSICIANS CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-988-6922
Mailing Address - Street 1:780 HIGHWAY 321 N STE 8
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-6589
Mailing Address - Country:US
Mailing Address - Phone:865-988-6922
Mailing Address - Fax:865-988-6296
Practice Address - Street 1:780 HIGHWAY 321 N STE 8
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6589
Practice Address - Country:US
Practice Address - Phone:865-988-6922
Practice Address - Fax:865-988-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3724224Medicare ID - Type Unspecified