Prodigal Primary Care Pc

LBN: Prodigal Primary Care Pc
Prodigal Primary Care Pc is an health care organization with primary practice located at 2911 Essary Road , Knoxville TN 37918-2468. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as the primary health care specialty. Prodigal Primary Care Pc can be contacted via phone (865) 288-2754, or through Brickhouse, David E via phone (865) 288-3754.

Contact Information

Primary practice address
2911 Essary Road Knoxville TN 37918-2468
Phone: (865) 288-2754
Fax: (865) 243-2250
Website:
Map and Directions
Authorized official contact:
Name: Brickhouse, David E
Phone: (865) 288-3754

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1506 Tennessee

Profile Details

NPI number 1861704371
LBN Legal business name Prodigal Primary Care Pc
DBA Doing business as
Authorized official Brickhouse, David E
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2010
Last updated Aug 21st, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861704371 NPPES
Tennessee MEDICAID 1521979

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