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NPI Code Detail

MEDICARE: MARY FRANCES FILONUK BA

MEDICARE: MARY FRANCES FILONUK BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1538304001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FRANCES FILONUK BA
Provider Business Mailing Address
First Line : 498 INDUSTRIAL DR
Second Line :
City : BRISTOL
State : TN
Zip : 37620-5400
Country : US
Telephone Number : 423-878-1600
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 1167 SPRATLIN PARK DR
Second Line :
City : GRAY
State : TN
Zip : 37615-6205
Country : US
Telephone Number : 423-467-3721
Fax Number : 423-467-3644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2008
Last Update Date : 12/11/2008

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Directions to “ MARY FRANCES FILONUK BA” Practice Location

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