Healthcare Provider Details

I. General information

NPI: 1316958044
Provider Name (Legal Business Name): LESTER DALE MCCARTNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 MEDICAL CENTER DRIVE.
COPPERHILL TN
37317
US

IV. Provider business mailing address

393 NEW HOPE LOOP
WHITWELL TN
37397-3620
US

V. Phone/Fax

Practice location:
  • Phone: 423-496-8150
  • Fax: 423-496-7095
Mailing address:
  • Phone: 423-949-7107
  • Fax: 423-949-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTN 26920
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: