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General NPI Number Information
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NPI Number | 1548392491
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Entity Type | Organization
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Legal Business Name | MULTISPECIALTY MEDICAL P.C.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 1610 TAZEWELL RD SE 201
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City | TAZEWELL
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State | TN
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Zip | 37879-3600
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Country | US
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Telephone | 423-626-8393
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Fax | 423-626-8749
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Provider Business Mailing Address
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Address Line | 1610 TAZEWELL RD SE 201
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City | TAZEWELL
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State | TN
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Zip | 37879-3600
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Country | US
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Telephone | 423-626-8393
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Fax | 423-626-8749
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. AMY LAMB
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Credential |
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Telephone | 423-626-8393
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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 | 38563
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License Number State | TN
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