Organization
NORTHEAST TENNESSEE EMERGENCY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARK WOODARD MD (PRESIDENT)
(423) 408-2960
Entity
Organization
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
(423) 398-5500
Mailing address
PO BOX 11827, DAYTONA BEACH, FL 32120-1827
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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