| NPI | 1306938352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT G FUGATE Credentialing 423-626-7297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |