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Organization
MOUNTAIN REGION FAMILY MEDICINE, PC
Active
Organization
MOUNTAIN REGION FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA TRENT (CORPORATE SECRETARY)
(423) 230-2109
Entity
Organization
Contact information
Practice address
101 PROFESSIONAL PARK PVT DR, KINGSPORT, TN 37663-2288
(423) 239-7300
(423) 239-8581
Mailing address
101 PROFESSIONAL PARK PVT DR, KINGSPORT, TN 37663-2288
(423) 239-7300
(423) 239-8581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
Other
Enumeration date
08/14/2006
Last updated
12/14/2017
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