Provider Demographics
NPI:1669410304
Name:EMERGENCY CARE PHYSICIANS, INC.
Entity type:Organization
Organization Name:EMERGENCY CARE PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOULDING
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:423-282-8299
Mailing Address - Street 1:3633 HONEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-1480
Mailing Address - Country:US
Mailing Address - Phone:423-282-8299
Mailing Address - Fax:
Practice Address - Street 1:401 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2028
Practice Address - Country:US
Practice Address - Phone:423-854-5880
Practice Address - Fax:423-854-5685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3732960Medicare ID - Type Unspecified