Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
UNIVERSITY PHYSICIANS PRACTICE GROUP- ETSU FM KINGSPORT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
102 RAVINE RD, STE 1, KINGSPORT, TN 37660
(423) 245-9600
(423) 245-9634
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/06/2007
Last updated
03/07/2023
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