Jack Homer Atkins III, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Louisville, TN
NPI 1104052216 · NPPES record last updated Jun 3, 2009
Key facts
- NPI
- 1104052216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 420 Post Ave
Louisville, TN 37777-6223 - Phone
- (865) 985-4277
- Fax
- (865) 985-4273
- NPI assigned
- Jun 3, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
420 Post Ave
Louisville, TN 37777-6223
Mailing address
420 Post Ave
Louisville, TN 37777-6223
Phone (865) 985-4277
Other providers in Louisville, TN
- Allied Medical Clinic, Inc.
- Scott E Anderson
- Abby Elizabeth Aurigema
- Katherine Ann Barker
- Vicky Kay Baumann
- Teddy Spencer Beaty
- Justin A Bennett
All providers in Louisville, TN · Independent Duty Medical Technicians in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.