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Organization

RENUVEN ACO PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BERT J SMITH MD (CEO)
(423) 557-5706
Entity
Organization

Contact information

Practice address
3209 BRISTOL HWY, JOHNSON CITY, TN 37601-1515
(423) 926-2358
Mailing address
2717 E OAKLAND AVE, JOHNSON CITY, TN 37601-1843
(423) 926-2358

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
07/12/2024
Last updated
07/12/2024
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