Organization
CORNELIUS J. MANCE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIUS JEFFERSON MANCE M.D. (PRESIDENT)
(423) 954-9556
Entity
Organization
Contact information
Practice address
2051 B HAMILL ROAD, HIXSON, TN 37343
(423) 877-1212
Mailing address
5309 INLET VIEW LANE, HIXSON, TN 37343
(423) 954-9556
(423) 954-9505
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3046304
—
TN
01
—
3074846
BLUECROSS/BLUESHIELD
TN
Enumeration date
10/03/2006
Last updated
08/22/2020
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