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NPI Code Detail

MEDICARE: KINGSPORT BRONCHOSCOPY CENTER, INC.

MEDICARE: KINGSPORT BRONCHOSCOPY CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center0000000054TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11000908OTHERTNBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306898416
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINGSPORT BRONCHOSCOPY CENTER, INC.
Provider Business Mailing Address
First Line : 111 W STONE DR
Second Line : SUITE 100
City : KINGSPORT
State : TN
Zip : 37660-6027
Country : US
Telephone Number : 423-247-5197
Fax Number : 423-247-5254
Provider Business Practice Location Address
First Line : 111 W STONE DR
Second Line : SUITE 100
City : KINGSPORT
State : TN
Zip : 37660-6027
Country : US
Telephone Number : 423-247-5197
Fax Number : 423-247-5254
Authorized Official
Title or Position : ADMINISTRATOR
Name : SHIRLEY HAWKINS
Credential :
Telephone Number : 423-247-5197
Provider Enumeration Date : 05/17/2006
Last Update Date : 02/28/2008

Similar Medicare Providers

1497758551 — MS. JANET CRADIC F.N.P.
Practice Location Address:
111 W STONE DR STE 110
KINGSPORT, TN
37660-6027
Practice Phone: 423-224-3701
Practice Fax: 423-224-3709
1689677304 — DR. JOSEPH LEY MD
Practice Location Address:
105 WEST STONE DRIVE , STE 2A
KINGSPORT, TN
37660-6027
Practice Phone: 423-224-3375
Practice Fax: 423-378-5970
1497748362 — WENDY HYCHE VOGEL NP
Practice Location Address:
111 W STONE DR , SUITE 300
KINGSPORT, TN
37660-6027
Practice Phone: 423-224-3150
Practice Fax: 423-224-3169
1487621272 — DR. EDWIN MCELROY JR. MD
Practice Location Address:
111 W STONE DR , SUITE 300
KINGSPORT, TN
37660-6027
Practice Phone: 423-224-3150
Practice Fax: 423-224-3169
1073565073 — PULMONARY ASSOCIATES OF KINGSPORT
Practice Location Address:
111 W STONE DR , SUITE 100
KINGSPORT, TN
37660-6027
Practice Phone: 423-247-5197
Practice Fax: 423-247-5254
1801849674 — MARK W EMERY MD
Practice Location Address:
111 W STONE DR , SUITE 100
KINGSPORT, TN
37660-6027
Practice Phone: 423-247-5197
Practice Fax: 423-247-5254

Directions to “KINGSPORT BRONCHOSCOPY CENTER, INC. ” Practice Location

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