Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
PSYCHIATRY DEPT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
LAKE DR., BLDG. 52, MOUNTAIN HOME, TN 37684-0699
(423) 439-8000
(423) 433-2200
Mailing address
PO BOX 2204, JOHNSON CITY, TN 37605-2204
(423) 433-6050
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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