Provider Demographics
NPI:1710382585
Name:PATIENT'S CLINIC
Entity type:Organization
Organization Name:PATIENT'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:NEKURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-353-1175
Mailing Address - Street 1:709 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3977
Mailing Address - Country:US
Mailing Address - Phone:423-851-4379
Mailing Address - Fax:
Practice Address - Street 1:709 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3977
Practice Address - Country:US
Practice Address - Phone:423-851-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512614Medicaid
TN1512614Medicaid
TN38670042Medicare PIN