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General NPI Number Information
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NPI Number | 1023209780
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Entity Type | Organization
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Legal Business Name | ASBURY INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 2725 ASBURY RD SUITE 103
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City | KNOXVILLE
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State | TN
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Zip | 37914-6441
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Country | US
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Telephone | 865-525-7220
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Fax | 865-525-7407
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Provider Business Mailing Address
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Address Line | 2725 ASBURY RD SUITE 103
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City | KNOXVILLE
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State | TN
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Zip | 37914-6441
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Country | US
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Telephone | 865-525-7220
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Fax | 865-525-7407
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. DAVID ALAN VASTINE
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Credential | M.D.
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Telephone | 865-525-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 39679
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License Number State | TN
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