Organization
MARK R. DOMAN, M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RICHARD DOMAN M.D. (PRESIDENT)
(423) 235-0063
Entity
Organization
Contact information
Practice address
113 N MAIN ST, BULLS GAP, TN 37711-4735
(423) 235-0063
(423) 235-0066
Mailing address
PO BOX 70, BULLS GAP, TN 37711-0070
(423) 235-0063
(423) 235-0066
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
21947
TN
Other
Enumeration date
11/01/2006
Last updated
10/23/2007
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