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Individual

PHILLIP E JUSTICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1700 PINEBROOK DR, STE. 2, KINGSPORT, TN 37660-4365
(423) 245-3170
Mailing address
2729 HIGHLAND GLEN CT, JOHNSON CITY, TN 37615-4595
(865) 385-9743

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2369
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528770
TN
Enumeration date
07/10/2009
Last updated
02/11/2019
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