Organization
MEDICAL ARTS PLAZA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT EUGENE DESJARLAIS M.D. (REGISTERED AGENT)
(423) 942-1602
Entity
Organization
Contact information
Practice address
980 HIGHWAY 28, SUITE 100, JASPER, TN 37347-3695
(423) 942-1602
(423) 942-1265
Mailing address
980 HIGHWAY 28, SUITE 100, JASPER, TN 37347-3695
(423) 942-1602
(423) 942-1265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25036
TN
363LF0000X
Family Nurse Practitioner
7170
TN
Other
Enumeration date
07/02/2012
Last updated
08/07/2013
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