Individual
JOHN D. CREASY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 968-1144
(423) 968-3453
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720
(423) 968-1144
(423) 968-3453
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2026013073
MO
2085R0202X
Diagnostic Radiology Physician
Primary
31555
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200008400
—
WV
01
—
300108603
PGA (RR MEDICARE)
—
01
—
3140729
BCBS
TN
05
—
3844447
—
TN
05
—
64008402
—
KY
05
—
7205066
—
VA
01
—
R06903
JOHN DEERE
TN
Enumeration date
08/10/2005
Last updated
05/14/2026
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