Individual
GARIK T MISENAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 926-6266
(423) 926-7599
Mailing address
PO BOX 5576, JOHNSON CITY, TN 37602-5576
(423) 926-6266
(423) 926-7599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101242546
VA
207P00000X
Emergency Medicine Physician
Primary
MD39742
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619084639
—
VA
05
—
3332120
—
TN
01
—
P00224900
RR MEDICARE
—
Enumeration date
08/24/2006
Last updated
08/07/2020
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