Individual
DR. NATHAN EDWARD GARGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
271 MEDICAL PARK BLVD, BRISTOL, TN 37620-7455
(423) 274-8600
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101278336
VA
207R00000X
Internal Medicine Physician
67893
TN
207R00000X
Internal Medicine Physician
Primary
MT199612
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HS000121L
LANKENAU HOSPITAL TRAINING LICENSE NUMBER
PA
01
—
MT199612
GRADUATE MEDICAL TRAINEE LICENSE NUMBER
PA
Enumeration date
06/06/2011
Last updated
02/20/2024
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