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NPI Code Detail

MEDICARE: E. TN OB-GYN P.C.

MEDICARE: E. TN OB-GYN P.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
1174400000XSpecialistTN

General Provider Information

NPI Number : 1942221924
Entity Type Code : Organization
Provider Name (Legal Business Name) : E. TN OB-GYN P.C.
Provider Business Mailing Address
First Line : 609 MCFARLAND ST
Second Line : 525 MCFARLAND STREET
City : MORRISTOWN
State : TN
Zip : 37814-3976
Country : US
Telephone Number : 423-586-2151
Fax Number : 423-586-0873
Provider Business Practice Location Address
First Line : 609 MCFARLAND ST
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3976
Country : US
Telephone Number : 423-586-2151
Fax Number : 423-586-0873
Authorized Official
Title or Position : CREDENTIAL DEPT
Name : MRS. MARY JONES
Credential :
Telephone Number : 423-586-2151
Provider Enumeration Date : 07/22/2006
Last Update Date : 07/21/2022

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