Individual
DEBORAH E. LECRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 W STONE DR STE 1F, KINGSPORT, TN 37660-3365
(423) 230-2420
(423) 230-2422
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2093
(423) 390-3340
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27625
TN
207R00000X
Internal Medicine Physician
MD27625
TN
208000000X
Pediatrics Physician
MD27625
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750498929
—
VA
05
—
3811990
—
TN
05
—
3811998
—
TN
Enumeration date
08/24/2006
Last updated
10/14/2020
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