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Physicians Neuromusculoskeletal Medicine, Sports Medicine

Provider NPI: 1235180480

Organization Information:
Organization is not Subpart
Authorized Official:  RUSSELL E LEWIS  EXECUTIVE DIRECTOR  423-433-6050

Practice Location:
Tel: 423-433-6039  Fax: 423-433-6060

Business Mailing Address:
PO BOX 699  MOUNTAIN HOME, TN 37684-0699 US
Tel: 423-433-6039  Fax: 423-433-6060

NPI Information:
NPI: 1235180480
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Neuromusculoskeletal Medicine, Sports Medicine
Allergy & Immunology
Family Medicine
Internal Medicine
Internal Medicine
Internal Medicine
Internal Medicine
Internal Medicine
Obstetrics & Gynecology
Obstetrics & Gynecology
Psychiatry & Neurology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207R00000X





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