Organization
FOUNDATION MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER TEAGUE GOOD (FACILITY DIRECTOR/OWNER)
(423) 202-3008
Entity
Organization
Contact information
Practice address
1730 OLD GRAY STATION RD, JOHNSON CITY, TN 37615-3869
(423) 202-3008
(423) 202-7835
Mailing address
1730 OLD GRAY STATION RD, JOHNSON CITY, TN 37615-3869
(423) 202-3008
(423) 202-7835
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
1000000022019
TN
Other
Enumeration date
04/17/2018
Last updated
07/24/2019
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