Provider Demographics
NPI:1063616407
Name:MEDICENTER & ASSOCIATES PLLC
Entity type:Organization
Organization Name:MEDICENTER & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GALYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-453-1122
Mailing Address - Street 1:1981 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37863-4904
Mailing Address - Country:US
Mailing Address - Phone:865-456-1122
Mailing Address - Fax:865-453-9754
Practice Address - Street 1:1981 PARKWAY
Practice Address - Street 2:
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-4904
Practice Address - Country:US
Practice Address - Phone:865-456-1122
Practice Address - Fax:865-453-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center