# FAMILY PRACTICE OF CORRYTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245752997
- **Authorized official:** KIM M DAUGHERTY (OFFICE MANAGER)
- **Authorized official phone:** (865) 992-3031

## Contact information

- **Practice address:** 7701 CORRYTON RD, CORRYTON, TN 37721-2630
- **Practice address phone:** (865) 247-6263
- **Practice address fax:** (865) 992-8103
- **Mailing address:** PO BOX 88, CORRYTON, TN 37721-0088
- **Mailing address phone:** (865) 992-3031
- **Mailing address fax:** (865) 992-8103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2017
- **Last updated:** 07/14/2017