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Physicians Otolaryngology

Provider NPI: 1013916865

Provider Information:
Gender: M

Practice Location:
Tel: 423-698-8981  Fax: 423-697-7109

Business Mailing Address:
Tel: 423-698-8981  Fax: 423-697-7109

NPI Information:
NPI: 1013916865
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number

Other Provider Identifiers:

BC/BS TN2002190TN01

American Medical Association 2012 taxonomy code information

Code: 207Y00000X





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