Individual
GENE D LE SAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
329 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6062
(423) 979-4100
(423) 979-4134
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 979-4100
(423) 979-4134
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD44073
TN
207RG0100X
Gastroenterology Physician
Primary
MD44073
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371440
GROUP MEDICARE NUMBER
TN
Enumeration date
07/10/2006
Last updated
05/03/2013
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