| NPI | 1750592689 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | WILLIE MAE HUBBARD Pediatrician/Owner 423-493-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-04-01 |