Individual
BRIAN E. INGALLS
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
(423) 439-7118
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-6464
(423) 439-7118
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD021725
TN
207Q00000X
Family Medicine Physician
Primary
MD21725
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000735424B
—
TN
Enumeration date
07/05/2006
Last updated
03/02/2020
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