Provider Demographics
NPI:1801177449
Name:MCMINN ORTOPAEDIC CLINIC, PC
Entity type:Organization
Organization Name:MCMINN ORTOPAEDIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-745-2344
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0688
Mailing Address - Country:US
Mailing Address - Phone:423-745-2344
Mailing Address - Fax:423-745-2314
Practice Address - Street 1:719 COOK DR STE 110
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3495
Practice Address - Country:US
Practice Address - Phone:423-745-2344
Practice Address - Fax:423-745-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO01701261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty