| NPI | 1093723330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CHILDERS Practice Administrator 423-478-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2011-03-22 |