Provider Demographics
NPI:1770750341
Name:APPALACHIAN MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:APPALACHIAN MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:WINDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-263-3600
Mailing Address - Street 1:DEPT AT 960339
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0001
Mailing Address - Country:US
Mailing Address - Phone:888-447-2450
Mailing Address - Fax:
Practice Address - Street 1:886 HIGHWAY 411 N
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-1912
Practice Address - Country:US
Practice Address - Phone:423-263-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506779Medicaid
TN4185158OtherBCBS OF TN
TNDN8699OtherRAILROAD MEDICARE
TN4185158OtherBCBS OF TN
TN1506779Medicaid