Healthcare Provider Details

I. General information

NPI: 1235244708
Provider Name (Legal Business Name): CENTER FOR APPLIED REPRODUCTIVE SCIENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N STATE OF FRANKLIN RD SUITE # 31
JOHNSON CITY TN
37604-6089
US

IV. Provider business mailing address

408 N STATE OF FRANKLIN RD SUITE # 31
JOHNSON CITY TN
37604-6089
US

V. Phone/Fax

Practice location:
  • Phone: 423-461-8880
  • Fax: 423-461-8887
Mailing address:
  • Phone: 423-461-8880
  • Fax: 423-461-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL S THATCHER
Title or Position: OWNER
Credential: MD,PHD
Phone: 423-461-8880