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Organization
PODIATRIC CLINICS OF NORTHEAST TN
Active
Organization
PODIATRIC CLINICS OF NORTHEAST TN
Active
Other names
Foot & Ankle Center
Organization subpart
No
Provider details
NPI number
Authorized official
SALLEE TAYLOR RANDOLPH (OWNER)
(423) 213-9961
Entity
Organization
Contact information
Practice address
1303 SUNSET DR STE 6, JOHNSON CITY, TN 37604-7905
(423) 232-1771
(423) 929-0328
Mailing address
206 PRINCETON RD STE 14, JOHNSON CITY, TN 37601-2025
(423) 232-1771
(423) 929-0328
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/04/2026
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