Individual
DR. DEMETRIO REBANO MACARIOLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 N STATE OF FRANKLIN RD, GROUND FLOOR, JOHNSON CITY, TN 37604-6062
(423) 439-7320
(423) 439-7343
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-7320
(423) 439-7343
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD43116
TN
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD43116
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506884
—
TN
Enumeration date
09/20/2006
Last updated
01/18/2024
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