Organization
PIONEER FOOT AND ANKLE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL KENT WILSON MD (OWNER)
(423) 854-0001
Entity
Organization
Contact information
Practice address
28 MIDWAY ST, BRISTOL, TN 37620-1706
(423) 854-0001
(423) 854-0002
Mailing address
926 WEST OAKLAND AVE STE 206, JOHNSON CITY, TN 37604-4100
(423) 854-0001
(423) 854-0002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM732
TN
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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