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Organization

JOHNSON CITY EMERGENCY PHYSICIANS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY MICHEAL HYDER (PRACTICE ADMINISTRATOR)
(423) 926-6266
Entity
Organization

Contact information

Practice address
1319 SUNSET DR, SUITE 201, JOHNSON CITY, TN 37604-3799
(423) 926-6266
(423) 926-7599
Mailing address
PO BOX 5576, JOHNSON CITY, TN 37602-5576
(423) 926-6266
(423) 926-7599

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3712683
TN
01
CC3910
RAILROAD MEDICARE
Enumeration date
07/28/2006
Last updated
11/05/2010
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