Organization
ELIE MANSOUR, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIE MANSOUR M.D. (OWNER)
(423) 562-4976
Entity
Organization
Contact information
Practice address
919 E CENTRAL AVE, SUITE 103, LA FOLLETTE, TN 37766-2777
(423) 562-4976
(423) 566-5896
Mailing address
919 E CENTRAL AVE, SUITE 103, LA FOLLETTE, TN 37766-2777
(423) 562-4976
(423) 566-5896
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD21870
TN
Other
Enumeration date
06/10/2006
Last updated
11/09/2007
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