| NPI | 1366560161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M LOCKE Billing Administrator 423-224-3250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363A00000X Physician Assistant | |
| 207Y00000X Otolaryngology | |
| 208600000X Surgery | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2010-11-05 |