| NPI | 1497126700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON WATTENBARGER Credentialing/Billing Manager 423-472-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD029059) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2015-10-13 |