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General NPI Number Information
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NPI Number | 1760743553
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Entity Type | Organization
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Legal Business Name | ASSOCIATED ORTHOPAEDICS OF KINGSPORT PC
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK BLVD SUITE 300 EAST
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-245-3161
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Fax | 423-857-8129
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Provider Business Mailing Address
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Address Line | 2202 N JOHN B DENNIS HWY SUITE 100
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City | KINGSPORT
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State | TN
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Zip | 37660-5904
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Country | US
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Telephone | 423-245-3161
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Fax | 423-857-8129
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. SANDRA J WELLS
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Credential |
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Telephone | 423-230-3870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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