| NPI | 1588786768 |
|---|---|
| Doing Business As | UNIVERSITY PHYSICIANS PRACTICE GROUP- ETSU FM KINGSPORT |
| Entity Type | Organization |
| Authorized Contact | RUSSELL E LEWIS Executive Director 423-433-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2023-03-07 |