| NPI | 1104159417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DOUGLAS PERSHING Owner 423-884-2308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0000010526) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |