| NPI | 1851419659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M LOCKE Billing Administrator 423-224-3250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 208000000X Pediatrics | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2010-04-22 |