Individual
DR. DAWN M NUCKOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
301 MED TECH PKWY, SUITE 240, JOHNSON CITY, TN 37604
(423) 794-5520
(423) 282-0720
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(423) 282-6940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO2590
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508120908
—
VA
05
—
Q013768
—
TN
Enumeration date
06/29/2012
Last updated
02/20/2025
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