MEDICARE: MR. PRATIK VAIDYA PA-C

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
1	363AM0700X	Medical Physician Assistant	4571	TN

General Provider Information

NPI Number	:	1568016913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PRATIK VAIDYA PA-C

Provider Business Mailing Address
First Line	:	1325 E CENTER ST
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2444
Country	:	US
Telephone Number	:	423-245-2078
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 E CENTER ST
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37664-2444
Country	:	US
Telephone Number	:	423-245-2078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2019
Last Update Date	:	04/15/2026

Similar Medicare Providers

1891798575 — DR. THOMAS ROGERS MD
Practice Location Address:

1325 E CENTER ST
KINGSPORT, TN
37664-2444

Practice Phone: 423-245-2078
Practice Fax: 423-245-2078

1912194028 — HOLSTON REGIONAL ALTERNATIVE MEDICINE
Practice Location Address:

1303 E CENTER ST
KINGSPORT, TN
37664-2444

Practice Phone: 423-384-4443
Practice Fax: 423-239-9649

1679741532 — HOLSTON REGIONAL COMPREHENSIVE MEDICINE
Practice Location Address:

1303 E CENTER ST
KINGSPORT, TN
37664-2444

Practice Phone: 423-384-9266
Practice Fax: 423-239-9649

1912616426 — KAYLEA BROOKE WATSON PA-C
Practice Location Address:

1325 E CENTER ST
KINGSPORT, TN
37664-2444

Practice Phone: 423-245-2078
Practice Fax:

1336152461 — EVA ANN ALTIZER NED LPC MHSP
Practice Location Address:

1570 WAVERTY RD , HOLSTON COUNSELING CTR
KINGSPORT, TN
37664

Practice Phone: 423-224-1300
Practice Fax: 423-224-1375

1467076158 — JON WIRSHELS MSN, FNP-BC
Practice Location Address:

608 MONTEZUMA RD
KINGSPORT, TN
37664-4247

Practice Phone: 423-297-2696
Practice Fax:

Directions to “ MR. PRATIK VAIDYA PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.