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Organization

BRISTOL DERMATOLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH RAY WARRICK M.D. (PRESIDENT)
(803) 546-7522
Entity
Organization

Contact information

Practice address
350 BLOUNTVILLE HWY, SUITE 201, BRISTOL, TN 37620-0213
(423) 217-1337
(423) 217-1249
Mailing address
350 BLOUNTVILLE HWY, SUITE 201, BRISTOL, TN 37620-0213
(423) 217-1337
(423) 217-1249

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40472
TN
207NS0135X
Procedural Dermatology Physician
40472
TN

Other

Enumeration date
07/26/2007
Last updated
09/01/2009
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