Provider Demographics
NPI:1194978148
Name:FAMILIES FIRST MEDICAL GROUP, PC
Entity type:Organization
Organization Name:FAMILIES FIRST MEDICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDDIE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-688-8999
Mailing Address - Street 1:2908 TAZEWELL PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-1878
Mailing Address - Country:US
Mailing Address - Phone:865-688-8999
Mailing Address - Fax:865-688-8090
Practice Address - Street 1:2908 TAZEWELL PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1878
Practice Address - Country:US
Practice Address - Phone:865-688-8999
Practice Address - Fax:865-688-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 26895207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD 26895OtherLICENSE NUMBER
TNA93212Medicare UPIN