Healthcare Provider Details
I. General information
NPI: 1174525307
Provider Name (Legal Business Name): MARIANNE E FILKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2005
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2408 SUSANNAH ST STE 1
JOHNSON CITY TN
37601-1765
US
IV. Provider business mailing address
137 HUGH GARLAND RD
JONESBOROUGH TN
37659-6969
US
V. Phone/Fax
- Phone: 423-434-6677
- Fax: 423-461-0000
- Phone: 423-483-1268
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD0000018009 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | 18009 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: