Provider Demographics
NPI:1487608824
Name:RHEA FAMILY PHYSICIANS, PC
Entity type:Organization
Organization Name:RHEA FAMILY PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:P
Authorized Official - Last Name:BACON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-775-4261
Mailing Address - Street 1:7794 RHEA COUNTY HWY
Mailing Address - Street 2:STE 101
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5981
Mailing Address - Country:US
Mailing Address - Phone:423-775-4261
Mailing Address - Fax:423-570-2008
Practice Address - Street 1:7794 RHEA COUNTY HWY
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5981
Practice Address - Country:US
Practice Address - Phone:423-775-4261
Practice Address - Fax:423-570-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN143332OtherBLUE CROSS BLUE SHIELD GR
TN3719172Medicare ID - Type UnspecifiedGROUP NUMBER