| NPI | 1679126056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK B MASON Practice Administrator 865-541-8053 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2022-11-16 |