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Organization

ID MICRO PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTON MAKI JR. MD (OWNER)
(423) 915-1126
Entity
Organization

Contact information

Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 915-1126
Mailing address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 915-1126
(423) 915-0635

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD38189
TN

Other

Enumeration date
06/18/2006
Last updated
01/24/2012
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