Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
UNIVERSITY PHYSICIANS PRACTICE GROUP-ETSU FAMILY MEDICINE JOHNSON CITY
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(423) 439-6464
(423) 439-7118
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
03/07/2023
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