# ELIE MANSOUR, MD, PC

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

## Provider details

- **NPI number:** 1366483299
- **Authorized official:** DR. ELIE MANSOUR M.D. (OWNER)
- **Authorized official phone:** (423) 562-4976

## Contact information

- **Practice address:** 919 E CENTRAL AVE, SUITE 103, LA FOLLETTE, TN 37766-2777
- **Practice address phone:** (423) 562-4976
- **Practice address fax:** (423) 566-5896
- **Mailing address:** 919 E CENTRAL AVE, SUITE 103, LA FOLLETTE, TN 37766-2777
- **Mailing address phone:** (423) 562-4976
- **Mailing address fax:** (423) 566-5896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | MD21870 | TN | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 11/09/2007