Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
ST. JUDE'S TRI-CITIES AFFILIATE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604
(423) 431-3950
(423) 431-3958
Mailing address
PO BOX 2204, JOHNSON CITY, TN 37605-2204
(423) 433-6050
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
12/20/2011
Last updated
08/22/2018
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