Organization
EAST TENNESSEE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY B CAIN (PRESIDENT)
(423) 442-2121
Entity
Organization
Contact information
Practice address
3959 HIGHWAY 411, MADISONVILLE, TN 37354-4417
(423) 442-2121
Mailing address
3959 HIGHWAY 411, MADISONVILLE, TN 37354-4417
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/19/2017
Last updated
06/09/2017
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