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General NPI Number Information
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NPI Number | 1326061292
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Entity Type | Organization
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Legal Business Name | COPPER BASIN FAMILY PRACTICE INC.
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 144 MEDICAL CENTER DR BLDG C
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City | COPPERHILL
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State | TN
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Zip | 37317-1138
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Country | US
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Telephone | 423-496-1788
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Fax | 423-496-1776
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Provider Business Mailing Address
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Address Line | PO BOX 1138
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City | COPPERHILL
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State | TN
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Zip | 37317-1138
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Country | US
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Telephone | 423-496-1788
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Fax | 423-496-1776
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT JAMES NORRIS
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Credential | MD
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Telephone | 423-496-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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