Organization
MEDICAL INTERACTIVE EDUCATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DOUGHERTY JR. M.D. (CHIEF MEDICAL OFFICER)
(865) 599-4409
Entity
Organization
Contact information
Practice address
106 W. SUMMIT HILL DR., SUITE 301, KNOXVILLE, TN 37902-1041
(865) 599-4409
(865) 546-5034
Mailing address
106 W. SUMMIT HILL DR., SUITE 301, KNOXVILLE, TN 37902-1041
(865) 599-4409
(865) 546-5034
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
8309
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3179569
—
TN
Enumeration date
05/25/2011
Last updated
05/25/2011
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