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General NPI Number Information
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NPI Number | 1942695358
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Entity Type | Organization
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Legal Business Name | DONALD H. DEATON, DO
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 1601 TAZEWELL RD
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City | TAZEWELL
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State | TN
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Zip | 37879-3609
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Country | US
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Telephone | 865-278-4074
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 473
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City | HARROGATE
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State | TN
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Zip | 37752-0473
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Country | US
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Telephone | 865-278-4074
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DONALD H DEATON JR.
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Credential | DO
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Telephone | 865-278-4074
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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 | 784
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License Number State | TN
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