Healthcare Provider Details
I. General information
NPI: 1447875356
Provider Name (Legal Business Name): MNS3, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2020
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 S GAY ST STE 700
KNOXVILLE TN
37929-9703
US
IV. Provider business mailing address
1090 MARTHA GLASS DR
JEFFERSON CITY TN
37760-2078
US
V. Phone/Fax
- Phone: 865-722-9186
- Fax: 423-402-8117
- Phone: 865-262-0300
- Fax: 833-985-2157
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DREW
R.
MONCRIEF
Title or Position: OWNER/PRESIDENT
Credential: DO
Phone: 573-280-7700