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Organization

WATAUGA ORTHOPAEDICS PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE ELIZABETH LYONS (CREDENTIALING SPECIALIST)
(423) 282-9011
Entity
Organization

Contact information

Practice address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1765
(423) 282-9011
(423) 282-0035
Mailing address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1765
(423) 282-9011
(423) 282-0035

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18545
TN
332B00000X
Durable Medical Equipment & Medical Supplies
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner
ANP18364
TN

Other

Enumeration date
07/22/2006
Last updated
06/26/2024
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