Stallion Medical Group P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1927 Issued in TN

Legal business name

STALLION MEDICAL GROUP P.C.

Doing business as

DeMaro Family Medicine

Practice address

598 John Deere Drive
Maynardville, TN 37807

Phone

(865) 832-8370

Fax

(865) 862-8366

NPI assigned

Oct 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paula Renee Demaro, P.A. - C

Title

Office Manager

Phone

(706) 464-3201

Specialties & licenses 1

Addresses

Other names 1

• DeMaro Family Medicine Doing business as

Practitioners 1

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

• Paula Renee Miksa, PA-C

  • Physician Assistant
  • Maynardville, TN
  • NPI 1548209463
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1669623898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 JOHN DEERE DRIVE",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "37807",
            "telephone_number": "865-832-8370",
            "fax_number": "865-862-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 JOHN DEERE DRIVE",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "37807",
            "telephone_number": "865-832-8370",
            "fax_number": "865-862-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STALLION MEDICAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "DEMARO",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-464-3201",
        "authorized_official_credential": "P.A. - C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeMaro Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anwyn Marie Skocy, M.S. CCC-SLP
• Lisa D Smallen-Lee
• Rehana Soomar, RN
• Alesia Renee Spain, SLP
• Margaret Stallard
• Brenda Stanley
• State of Tennessee (Union County Health Department)
• Alexandria Lea Sturgell, PHARMD
• Heather Sucklilng, OTR/L
• Summit Medical Group, PLLC (Caring Medical Center)

• Family Medicine Physician in Maynardville, TN
• Providers in Maynardville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.