Healthcare Provider Details

I. General information

NPI: 1083897730
Provider Name (Legal Business Name): MORRISTOWN FOOT CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1457 W MORRIS BLVD SUITE D
MORRISTOWN TN
37813-2828
US

IV. Provider business mailing address

1457 W MORRIS BLVD SUITE D
MORRISTOWN TN
37813-2828
US

V. Phone/Fax

Practice location:
  • Phone: 423-581-9070
  • Fax: 423-581-9303
Mailing address:
  • Phone: 423-581-9070
  • Fax: 423-581-9303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberDPM440
License Number StateTN

VIII. Authorized Official

Name: DR. JULIE JOHNSON JONES
Title or Position: PRESIDENT
Credential: DPM
Phone: 423-581-9070