Organization
EAST TENNESSEE CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN A PEOPLES (VP)
(615) 465-7585
Entity
Organization
Contact information
Practice address
502 W 7TH NORTH ST, MORRISTOWN, TN 37814-3957
(423) 586-1818
(423) 586-5989
Mailing address
502 W 7TH NORTH ST, MORRISTOWN, TN 37814-3957
(423) 586-1818
(423) 586-5989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1521155
—
TN
Enumeration date
08/31/2010
Last updated
07/31/2012
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