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Organization
WATAUGA LAKE FAMILY MEDICINE PC
Active
Organization
WATAUGA LAKE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY R. MILLER (BUSINESS MANAGER)
(336) 982-2158
Entity
Organization
Contact information
Practice address
140 MCQUEEN ST., BUTLER, TN 37640
(423) 768-0195
Mailing address
138 N FORK NEW RIVER RD, LANSING, NC 28643-9130
(336) 982-2158
(336) 982-3373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000041068
TN
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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