Organization
FIRST CHOICE NEUROSURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE P HARTMAN M.D. (OWNER)
(423) 392-9300
Entity
Organization
Contact information
Practice address
135 W RAVINE RD, SUITE 4-A, KINGSPORT, TN 37660-3847
(423) 392-9300
(423) 392-9365
Mailing address
135 W RAVINE RD, SUITE 4-A, KINGSPORT, TN 37660-3847
(423) 392-9300
(423) 392-9365
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
139176
TN
261QM2500X
Medical Specialty Clinic/Center
Primary
36815
TN
332B00000X
Durable Medical Equipment & Medical Supplies
36815
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010165610
—
VA
01
—
177322
ANTHEM BCBS VA
TN
05
—
3729788
—
TN
01
—
4103830
BCBS TN
TN
01
—
4205736
AETNA
TN
01
—
61504100
OWCP
TN
05
—
64059660
—
KY
01
—
9454636
CIGNA
TN
01
—
DD3260
RR MEDICARE
TN
Enumeration date
01/17/2007
Last updated
05/15/2013
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