Individual
ANN GROCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
135 W RAVINE RD, STE 5B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465
Mailing address
PO BOX 1308, KINGSPORT, TN 37662-1308
(423) 224-3460
(423) 224-3465
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13080
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00013859
NHC CARE ADMINISTRATORS
—
01
—
050011789
RAILROAD MEDICARE
—
01
—
063141
ANTHEM BCBS
—
01
—
100010283
PHP TENNCARE
—
01
—
3046933
BLUE SHIELD OF TN
—
05
—
3183511
—
TN
05
—
5747643
—
VA
05
—
5900464
—
NC
05
—
64775992
—
KY
01
—
TN0100
JOHN DEER
—
Enumeration date
08/22/2005
Last updated
06/26/2008
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