Individual
DR. EDWARD JOHNSON FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 W STONE DR, SUITE 4A, KINGSPORT, TN 37660-3256
(423) 392-6265
(423) 392-6272
Mailing address
3601 SW 160TH AVE STE 250, MIRAMAR, FL 33027-6314
(877) 866-7123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000026800
TN
208600000X
Surgery Physician
MD26800
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346221157
—
VA
05
—
3700364
—
TN
05
—
3826258
—
TN
Enumeration date
11/09/2005
Last updated
03/15/2018
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