Individual
MAYNARD W AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1404 TUSCULUM BLVD, LAUGHLIN MOB, SUITE 3100, GREENEVILLE, TN 37745-4395
(423) 638-4114
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
06304
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110190591
RR MEDICARE
TN
05
—
3145919
—
TN
Enumeration date
06/21/2006
Last updated
01/05/2010
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