Individual
SAMANTHA UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
424 N BROAD ST, NEW TAZEWELL, TN 37825-6606
(423) 259-5700
Mailing address
424 N BROAD ST, NEW TAZEWELL, TN 37825-6606
(423) 259-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5757
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q087632
—
TN
Enumeration date
10/18/2023
Last updated
11/01/2023
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