| NPI | 1952557381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HARRELL Accounting Supervisor 865-218-6109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO MD42643) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN5961) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2021-01-20 |