1619258308

Everything you always wanted to know about LENSGRAF CLINIC, PC 3 WASHINGTON COUNTY MEDICAL DR. LENSGRAF D ARTHUR but were afraid to ask.

LENSGRAF CLINIC, PC 3 WASHINGTON COUNTY MEDICAL DR. LENSGRAF D ARTHUR

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Organization Name Other Organization Name Type Code Other Organization Name Authorized Official Prefix Authorized Official Last Name Authorized Official Middle Name Authorized Official First Name
LENSGRAF CLINIC, PC 3 WASHINGTON COUNTY MEDICAL DR. LENSGRAF D ARTHUR
Gender:
none
Enumeration date:
2011-09-08
Last update date:
2013-08-30
Current as of:
2007-08-28
Is sole proprietor?:
Not Answered
Is organization subpart?:
No
In PECOS?:
No

Identifiers

identifier description issuer state active
103G701723 Medicare PIN none TN 1
6611580001 Medicare NSC none TN 1
1525482 Medicaid none TN 1
1619258308 Medicaid none VA 1

Taxonomies

Taxonomy State License Number Primary?
111N00000X Chiropractor TN 2502
207LP2900X Pain Medicine TN 43044
363A00000X Physician Assistant TN 1826
363LF0000X Family TN 15106
207Q00000X Family Medicine TN MD18742

Phone Numbers

Type Number
Mailing Address Telephone Number 8653306320
Practice Location Address Telephone Number 8653306320
Authorized Official Telephone Number 8653306320
Mailing Address Fax Number 8653306323
Practice Location Address Fax Number 8653306323

Addresses

Type Address City State Postal Country
Mailing Address 818 SUNSET DR SUITE 103 JOHNSON CITY TN 37604 TN
Practice Location Address 818 SUNSET DR SUITE 103 JOHNSON CITY TN 37604 TN

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Other NPI Records that share an address

NPI Name Address State City
1104107754 HEITMANN, KELLIE
Individual
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Individual
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818 SUNSET DR TN JOHNSON CITY
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Organization
818 SUNSET DR TN JOHNSON CITY