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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
MS. WANDA Y TRENT (CORPORATE SECRETARY)
(423) 230-2109
Entity
Organization
Contact information
Practice address
444 CLINCHFIELD STREET, STE 201, KINGSPORT, TN 37660-3683
(423) 230-2100
(423) 230-2112
Mailing address
444 CLINCHFIELD STREET, STE 201, KINGSPORT, TN 37660-3683
(423) 230-2100
(423) 230-2112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
Other
Enumeration date
12/02/2011
Last updated
03/10/2017
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