Individual
ANNA VIMALA JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1047 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1639
(606) 549-2656
Mailing address
PO BOX 540, JELLICO, TN 37762-0540
(423) 784-8492
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60344
KY
208000000X
Pediatrics Physician
73817
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2022
Last updated
05/06/2025
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