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Individual

MR. GEORGE A FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
408 N STATE OF FRANKLIN RD, SUITE 31B, JOHNSON CITY, TN 37604-6089
(423) 431-4946
(423) 431-4947
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 31B, JOHNSON CITY, TN 37604-6089
(423) 431-4946
(423) 431-4947

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
52555
TN
2080P0205X
Pediatric Endocrinology Physician
Primary
52555
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1750525713
VA
05
7100432280
KY
05
Q013984
TN
Enumeration date
04/21/2009
Last updated
02/04/2021
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