Organization
INTERNAL MEDICINE AND PEDIATRIC ASSOC OF BRISTOL
Active
Organization
INTERNAL MEDICINE AND PEDIATRIC ASSOC OF BRISTOL
Active
Other names
internal medicine and pediatric associates of bristol pc
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L MOODY (PRACTICE EXECUTIVE)
(423) 844-6704
Entity
Organization
Contact information
Practice address
350 STEELES ROAD, BRISTOL, TN 37620-9532
(423) 844-6700
(423) 844-6703
Mailing address
350 STEELES RD STE 2, BRISTOL, TN 37620-9532
(423) 844-6700
(866) 334-7495
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
TN
207R00000X
Internal Medicine Physician
Primary
—
TN
208000000X
Pediatrics Physician
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3707101
TNCARE PN
TN
01
—
CG2912
MEDICARE RAILROAD
SD
Enumeration date
05/23/2006
Last updated
05/04/2026
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