Provider Demographics
NPI:1699498709
Name:DHP MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:DHP MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-993-4047
Mailing Address - Street 1:1034 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-4257
Mailing Address - Country:US
Mailing Address - Phone:865-993-4047
Mailing Address - Fax:865-993-4194
Practice Address - Street 1:1034 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BEAN STATION
Practice Address - State:TN
Practice Address - Zip Code:37708-4257
Practice Address - Country:US
Practice Address - Phone:865-993-4047
Practice Address - Fax:865-993-4194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service