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General NPI Number Information
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NPI Number | 1831831254
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Entity Type | Organization
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Legal Business Name | SMOKY MOUNTAIN CARDIOLOGY INC
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 2815 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3216
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Country | US
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Telephone | 760-834-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 5220 ASPEN AVE
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City | MORRISTOWN
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State | TN
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Zip | 37813-4316
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Country | US
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Telephone | 760-834-1880
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARK HOLT
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Credential | MD
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Telephone | 760-834-1880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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