Individual
DR. MARC A. FAGELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., CCC-A
Contact information
Practice address
156 S. DOSSETT DRIVE, JOHNSON CITY, TN 37614
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-4515
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
0000001136
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3198223
—
TN
Enumeration date
07/05/2006
Last updated
01/17/2024
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