Individual
DR. RAY WALLACE METTETAL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 E 11TH AVE, JOHNSON CITY, TN 37601-3932
(423) 341-7538
Mailing address
303 E 11TH AVE, JOHNSON CITY, TN 37601-3932
(423) 341-7538
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD 10753
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086382
BC BS
VA
Enumeration date
07/07/2007
Last updated
07/08/2007
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