Individual
MR. PAUL DIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2202 JOHN B DENNIS HWY, SUITE 100, KINGSPORT, TN 37660
(423) 245-3161
(423) 857-8129
Mailing address
2202 JOHN B DENNIS HWY, SUITE 100, KINGSPORT, TN 37660
(423) 245-3161
(423) 857-8129
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA000243
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008929785
—
VA
05
—
3669582
—
TN
01
—
PA000243
LICENSE
TN
Enumeration date
06/12/2006
Last updated
05/02/2012
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