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Individual

STEPHEN T GORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
908 W 4TH NORTH ST, MORRISTOWN, TN 37814
(423) 586-4231
(865) 291-3228
Mailing address
286 WILMORE DR, WHITE PINE, TN 37890-4734

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101050730
TN
207P00000X
Emergency Medicine Physician
9400256
NC
208M00000X
Hospitalist Physician
0101050730
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508807876
VA
05
3011285
TN
05
64922552
KY
01
NCV266A
MEDICARE PTAN
NC
Enumeration date
06/09/2006
Last updated
06/11/2018
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