Organization
PRIMARY CARE & GERIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJEEV GUPTA MD (OWNER)
(423) 317-7412
Entity
Organization
Contact information
Practice address
1621 W MORRIS BLVD STE C, MORRISTOWN, TN 37813-2969
(423) 317-7412
(423) 317-7415
Mailing address
1621 W MORRIS BLVD STE C, MORRISTOWN, TN 37813-2969
(423) 317-7412
(423) 317-7415
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
APN00000019620
TN
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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