| NPI | 1871771683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY JARNIGAN Practice Administrator 865-540-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD18077) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-02-04 |