Individual
DR. LORI ANN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 542-5109
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 431-0509
(423) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200701334
NC
207Q00000X
Family Medicine Physician
35082925
OH
207Q00000X
Family Medicine Physician
38090
KY
207Q00000X
Family Medicine Physician
Primary
47644
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023U2
BLUE CROSSS BLUE SHIELD OF NC
NC
01
—
DR0646
RAILROAD MEDICARE
NC
Enumeration date
06/15/2006
Last updated
02/20/2018
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