Individual
DR. CRAIG MATHERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 MED TECH PKWY, STE 240, JOHNSON CITY, TN 37604
(423) 794-5520
(423) 282-6940
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(423) 282-6940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30967
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532440
—
TN
05
—
1558729
—
LA
01
—
30967
MEDICAL LICENSE
TN
Enumeration date
06/30/2006
Last updated
02/20/2025
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