# BISHOFBERGER MEDICAL ASSOCIATES OF EAST TENNESSEE

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

## Provider details

- **NPI number:** 1649442237
- **Authorized official:** THOMAS E BISHOFBERGER MD (OWNER)
- **Authorized official phone:** (423) 784-1300

## Contact information

- **Practice address:** 188 HOSPITAL LN, JELLICO, TN 37762-4400
- **Practice address phone:** (423) 784-1300
- **Practice address fax:** (423) 784-1420
- **Mailing address:** 1381 RELIABLE PKWY, CHICAGO, IL 60686-0013
- **Mailing address phone:** (317) 216-2528
- **Mailing address fax:** (317) 216-2894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 41757 | TN | — |
| 261QM2500X | Medical Specialty Clinic/Center | 41757 | TN | Yes |

## Other

- **Enumeration date:** 03/24/2008
- **Last updated:** 12/01/2011