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General NPI Number Information
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NPI Number | 1629408703
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Entity Type | Organization
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Legal Business Name | JOHN N. GERNERT
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 105 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37311-1704
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Country | US
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Telephone | 423-476-3773
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Fax | 423-476-8529
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Provider Business Mailing Address
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Address Line | 105 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37311-1704
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Country | US
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Telephone | 423-476-3773
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Fax | 423-476-8529
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Authorized Official
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Title or Position | OFFICE MANAGER/AM
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Name | MS. TANNA GREEN
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Credential |
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Telephone | 423-476-3773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM0000000198
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License Number State | TN
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