Individual ProviderEric HadleyFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address102 E Ravine Rd, Kingsport, TN 37660-3814(423) 245-9600PECOS EnrollmentBased on the most recent information from CMS, provider Eric Hadley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1780044552Provider TypeIndividualFull NameHadley, EricGenderMaleSole ProprietorNoEnumeration Date3/7/2016Last Updated3/16/2021Contact InformationPractice LocationPractice Address102 E Ravine Rd, Kingsport, TN 37660-3814Phone(423) 245-9600FaxUnlisted FaxMailing LocationMailing Address615 Lake Forest Ln Apt H3, Norton Shores, MI 49441-4733PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense2019-01678North CarolinaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer