# KINGSTON FAMILY PRACTICE, P.C.

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

## Provider details

- **NPI number:** 1356432041
- **Authorized official:** DWIGHT H WILLETT M.D. (PRESIDENT)
- **Authorized official phone:** (865) 376-3406

## Contact information

- **Practice address:** 820 W RACE ST, KINGSTON, TN 37763-2120
- **Practice address phone:** (865) 376-3406
- **Practice address fax:** (865) 376-9091
- **Mailing address:** 820 W RACE ST, KINGSTON, TN 37763-2120
- **Mailing address phone:** (865) 376-3406
- **Mailing address fax:** (865) 376-9091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 05/10/2023