# MEDICAL EDUCATION ASSISTANCE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST. JUDE'S TRI-CITIES AFFILIATE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316216336
- **Authorized official:** MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (423) 433-6050

## Contact information

- **Practice address:** 400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604
- **Practice address phone:** (423) 431-3950
- **Practice address fax:** (423) 431-3958
- **Mailing address:** PO BOX 2204, JOHNSON CITY, TN 37605-2204
- **Mailing address phone:** (423) 433-6050
- **Mailing address fax:** (423) 433-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | Yes |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2011
- **Last updated:** 08/22/2018