Provider Demographics
NPI:1366607277
Name:POLYCLINICS.NET, PLLC
Entity type:Organization
Organization Name:POLYCLINICS.NET, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-285-1690
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37384-0189
Mailing Address - Country:US
Mailing Address - Phone:423-285-1690
Mailing Address - Fax:423-285-1691
Practice Address - Street 1:721 BRYAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-6275
Practice Address - Country:US
Practice Address - Phone:423-285-1690
Practice Address - Fax:423-285-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNN/A261QU0200X, 261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care