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1386620169
FRASER G TUDIVER
JOHNSON CITY, TN
NPI
1386620169
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TN 36003)
Enumeration Date
2005-12-22
Last Update Date
2010-11-08
Business Address
FRASER G TUDIVER M.D.
917 W WALNUT ST
JOHNSON CITY, TN 37604-6527
Phone number: 423-439-6464
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Mailing Address
FRASER G TUDIVER M.D.
P.O. BOX 699
MOUNTAIN HOME, TN 37684
Phone number: 423-439-6464
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