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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
BHRHC Mt. City, MSMG FP IM MTN
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE TAYLOR (CEO)
(423) 542-1333
Entity
Organization
Contact information
Practice address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1100
(423) 727-1105
Mailing address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1100
(423) 727-1105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/09/2006
Last updated
08/12/2024
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