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Organization

JOHNSON CITY UROLOGICAL CLINIC, P.C.

Active
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Organization

JOHNSON CITY UROLOGICAL CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRANT D TAYLOR M.D. (OWNER)
(423) 926-6112
Entity
Organization

Contact information

Practice address
2340 KNOB CREEK ROAD, SUITE 720, JOHNSON CITY, TN 37604-2977
(423) 926-6112
(423) 434-0278
Mailing address
2340 KNOB CREEK ROAD, SUITE 720, JOHNSON CITY, TN 37604-2977
(423) 926-6112
(423) 434-0278

Taxonomy

Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
—
NULL
2088P0231X
Pediatric Urology Physician
Primary
—
—

Other

Enumeration date
03/22/2007
Last updated
08/19/2009
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