Individual
ROBERT KOUTSOUVELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(423) 439-6464
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72059
TN
Other
Enumeration date
07/21/2021
Last updated
10/15/2024
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