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NPI Code Detail

MEDICARE: FRONTIER HEALTH

MEDICARE: FRONTIER HEALTH
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
1261QM0850XAdult Mental Health Clinic/CenterL 229-076-1429TN
2261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1730245010
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRONTIER HEALTH
Provider Business Mailing Address
First Line : PO BOX 9054
Second Line :
City : GRAY
State : TN
Zip : 37615-9054
Country : US
Telephone Number : 423-467-3600
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 2243 EDDIE WILLIAMS RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2872
Country : US
Telephone Number : 423-928-5627
Fax Number : 423-928-4222
Authorized Official
Title or Position : DIR. CONTRACTING/COMPLIANCE
Name : DR. CRISTI L BLALOCK
Credential : MBA
Telephone Number : 423-467-3741
Provider Enumeration Date : 12/29/2006
Last Update Date : 08/11/2025

Similar Medicare Providers

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2243 EDDIE WILLIAMS RD
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1093835290 — MRS. BARBARA S BAXLEY
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1740450741 — VONDA KARLA WAGNER MA
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1851562904 — CINDY ALYNE THURLOW
Practice Location Address:
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1538332051 — LAURA M WHITSON MSW
Practice Location Address:
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Directions to “FRONTIER HEALTH ” Practice Location

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