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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