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Individual

GERARDO GARCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
2000 BROOKSIDE DR, 3RD FLOOR, KINGSPORT, TN 37660-4627
(423) 857-5905
(423) 857-5904
Mailing address
2000 BROOKSIDE DR, 3RD FLOOR, KINGSPORT, TN 37660-4627
(423) 857-5905
(423) 857-5904

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0116022013
VA
207R00000X
Internal Medicine Physician
TP386
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497082895
VA
05
7100238670
KY
01
P01200420
RAILROAD MEDICARE
TN
05
Q000344
TN
Enumeration date
11/06/2009
Last updated
10/28/2016
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