Individual
TERRY R NYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1916 BROOKSIDE DR, KINGSPORT, TN 37660-4602
(423) 392-6000
(423) 392-6030
Mailing address
1916 BROOKSIDE DR, KINGSPORT, TN 37660-4602
(423) 392-6000
(423) 392-6030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD37487
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3886833
—
TN
01
—
4104284
BCBS
TN
01
—
TN01U6
JOHN DEERE
TN
Enumeration date
04/22/2006
Last updated
03/02/2015
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