Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
UNIVERSITY PHYSICIANS PRACTICE GROUP, ETSU Physicians and Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
101 MED TECH PKWY STE 306, JOHNSON CITY, TN 37604-4001
(423) 433-6039
(423) 433-6060
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Enumeration date
05/12/2006
Last updated
01/14/2026
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