Elie Mansour, MD, PC – Pulmonary Disease Physician

Key facts

NPI: 1366483299
Entity type: Organization (NPI type 2)
Primary specialty: Pulmonary Disease Physician 207RP1001X
License: MD21870 (TN)
Legal business name: ELIE MANSOUR, MD, PC
Practice address: 919 E Central Ave
Suite 103
La Follette, TN 37766-2777
Phone: (423) 562-4976
Fax: (423) 566-5896
NPI assigned: Jun 10, 2006
Organization subpart: No

Authorized official

Name: Dr. Elie Mansour, M.D. NPI 1942246145
Title: Owner
Phone: (423) 562-4976

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Elie Mansour, M.D. Pulmonary Disease Physician · La Follette, TN · NPI 1942246145

Medicare reassignment NPD Authorized official PULMONARY DISEASE · TN

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20050415000573	TN	Part B Supplier - Clinic/Group Practice	6800833393	Receives reassigned benefits from 1 practitioner Practice locations: La Follette, TN

National Provider Directory

Locations

919 East Ave
Ste 103
La Follette, TN 37766
Phone (423) 562-4970

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pulmonary Disease Physician Group: 193400000X SINGLE SPECIALTY GROUP	207RP1001X	MD21870	TN	Yes

Addresses

Primary practice location

919 E Central Ave
Suite 103
La Follette, TN 37766-2777

Mailing address

919 E Central Ave
Suite 103
La Follette, TN 37766-2777
Phone (423) 562-4976

Other providers in La Follette, TN

East Tennessee Children'S Primary Care Center, Inc.
Eastlake Medical, PLLC
Hannah Echols, FNP-C
Greg Duane Edwards, PHARMD
Jessica Edwards, OT
Christina Sampieri Elkins
Elaine Hitch Ervin, DPT
Bill R Fannon Jr., DPH
James C Farris, M.D.
Fast Pace Medical Clinic PLLC

All providers in La Follette, TN · Pulmonary Disease Physician in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.