Organization
FAMILY PRACTICE OF CORRYTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM M DAUGHERTY (OFFICE MANAGER)
(865) 992-3031
Entity
Organization
Contact information
Practice address
7701 CORRYTON RD, CORRYTON, TN 37721-2630
(865) 247-6263
(865) 992-8103
Mailing address
PO BOX 88, CORRYTON, TN 37721-0088
(865) 992-3031
(865) 992-8103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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