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Eastlake Primary Care Llc
Primary Care Clinic/Center in Jacksboro, Tennessee
NPI 1972043214

Eastlake Primary Care Llc is a Primary Care Clinic/Center based in Jacksboro, TN and is specialized in Primary Care. Eastlake Primary Care Llc practices in Jacksboro, TN. The NPI Number for Eastlake Primary Care Llc is 1972043214 and holds a License No. (Tennessee).

The current practice location address for Eastlake Primary Care Llc is 2500 Jacksboro Pike Ste 6, Jacksboro, TN and can be reached out via phone at 423-352-6500 and via fax at 423-352-6501.

Location: 2500 Jacksboro Pike Ste 6, Jacksboro, TN, 37757
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972043214
Provider Name
Eastlake Primary Care Llc
Credential
Provider Entity Type
Organization
Address
2500 Jacksboro Pike Ste 6, Jacksboro, TN, 37757
Phone Number
423-352-6500
Fax Number
423-352-6501
Provider Enumeration Date
03/06/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q027747 05 TN
institution
Provider Business Practice Location Address Details
Address
2500 Jacksboro Pike Ste 6
City
Jacksboro
State
Tennessee
Zip
37757-2818
Phone Number
423-352-6500
Fax Number
423-352-6501
person
Provider Business Mailing Address Details
Address
2500 Jacksboro Pike Ste 6
City
Jacksboro
State
Tennessee
Zip
37757-2818
Phone Number
423-352-6500
Fax Number
423-352-6501
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
(Tennessee)
Definition
Definition to come...
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