is a Urology in Kingsport, Tennessee. practices all healthcare services and medical treatments related to Urology. The NPI Number for is 1104878388. The last update date is .
's current location address is 822 Broad St, Kingsport, Tennessee. You can contact this provider via phone number 4232466251 and fax number 4232467230. The mailing address for is 822 Broad St, Kingsport, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 822 Broad St, Kingsport, Tennessee |
| Phone Number | 4232466251 |
| Fax Number | 4232467230 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1104878388 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 822 Broad St |
|---|---|
| City | Kingsport |
| State | Tennessee (TN) |
| Post Code | 376603718 |
| Phone Number | 4232466251 |
| Fax Number | 4232467230 |
Provider's Primary Taxonomy Detail
| Speciality | Urology |
|---|---|
| Taxonomy | 208800000X |
| Licence No | 10808 |
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Definition: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquir |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 213340004 | DMERC | ||
| 62086999803 | JOHN DEERE | ||
| 43070 | VA | ANTHEM | |
| 7574258 | VA | -- | |
| 2003575 | TN | BLUECROSS BLUESHIELD |
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