| NPI | 1043322415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOHNSON FORE Medical Doctor 423-743-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD0000026800) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |