Organization
LECONTE RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G NIETHAMMER III MD (PRESIDENT)
(865) 548-4004
Entity
Organization
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 548-4004
(865) 980-4962
Mailing address
PO BOX 1445, INDIANAPOLIS, IN 46206-1445
(865) 588-2928
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3373480
—
TN
05
—
65935397
—
KY
01
—
CJ2946
RR MCARE
TN
01
—
TN0100
JOHN DEERE
TN
Enumeration date
03/27/2006
Last updated
02/02/2024
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