| NPI | 1376083907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP A. BANNOR Physician 423-760-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: TN 35052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 35052) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |