# MEDICAL EDUCATION ASSISTANCE CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDICAL EDUCATION ASSISTANCE CORPORATION D.B.A. ETSU PHYSICIANS & ASSO
- **Other names:** UNIVERSITY PHYSICIANS PRACTICE GROUP-ETSU FAMILY MEDICINE BRISTOL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710009907
- **Legal business name:** MEDICAL EDUCATION ASSISTANCE CORPORATION D.B.A. ETSU PHYSICIANS & ASSO
- **Authorized official:** RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (423) 433-6050

## Contact information

- **Practice address:** 208 MEDICAL PARK BLVD, BRISTOL, TN 37620
- **Practice address phone:** (423) 989-4050
- **Practice address fax:** (423) 990-3044
- **Mailing address:** PO BOX 699, MOUNTAIN HOME, TN 37684-0699
- **Mailing address phone:** (423) 433-6039
- **Mailing address fax:** (423) 433-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 03/07/2023