Organization
PSYCHIATRIC ASSOCIATES OF KINGSPORT LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC D MOFFET M.D. (M.D. PARTNER)
(423) 392-6500
Entity
Organization
Contact information
Practice address
444 CLINCHFIELD ST STE 101, KINGSPORT, TN 37660-3859
(423) 392-6500
(423) 392-6504
Mailing address
444 CLINCHFIELD ST STE 101, KINGSPORT, TN 37660-3859
(423) 392-6500
(423) 392-6504
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD0000013797
TN
2084P0800X
Psychiatry Physician
MD0000016494
TN
2084P0800X
Psychiatry Physician
Primary
MD0000020620
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018152
SMITH BCTN
TN
01
—
0048066
KUTTY BC TN
TN
01
—
0105831
MOFFET BCTN
TN
01
—
069097
KUTTY BC VA
VA
01
—
069098
SMITH BCVA
VA
01
—
069099
MOFFET BCVA
VA
05
—
3016081
—
TN
05
—
3052859
—
TN
05
—
3189819
—
TN
Enumeration date
09/12/2006
Last updated
07/07/2020
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