Individual
LARRY J FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Mailing address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0101233194
VA
207RP1001X
Pulmonary Disease Physician
Primary
13040
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014583
BLUE CROSS BLUE SHIELD
TN
01
—
006004229
VIRGINIA MEDICAID
VA
01
—
055802
ANTHEM
VA
01
—
100024258
PHP TENN CARE
TN
05
—
1000908
—
TN
05
—
3184714
—
TN
01
—
39708
UNITED HEALTHCARE
TN
01
—
5464032
AETNA
TN
01
—
62134825603
JOHN DEERE HEALTHCARE
TN
01
—
64749120
KENTUCKY MEDICAID
KY
01
—
Z101
UNITED HEALTHCARE OF THE RIVER VALLEY
TN
Enumeration date
05/19/2006
Last updated
07/27/2012
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