Individual
JOHN DAVID FENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 SUNSET DR, SUITE 105, JOHNSON CITY, TN 37604
(423) 282-1930
(423) 283-0608
Mailing address
302 SUNSET DR, SUITE 105, JOHNSON CITY, TN 37604
(423) 282-1930
(423) 283-0608
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0192735
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3005600
BCBS
TN
01
—
4293750
AETNA
—
Enumeration date
11/22/2006
Last updated
07/08/2007
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