Organization
SONI AND SONI PEDIATRICS AND SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTY D IRVIN (OFFICE MANAGER)
(423) 263-1147
Entity
Organization
Contact information
Practice address
109 GRADY RD STE B, ETOWAH, TN 37331-1919
(423) 263-6486
(423) 263-5704
Mailing address
PO BOX 500, ETOWAH, TN 37331-0500
(423) 263-1147
(423) 263-5704
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9198
TN
Other
Enumeration date
06/25/2007
Last updated
08/22/2020
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