Individual
KAIS A BALBISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
329 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6062
(423) 979-4100
(423) 979-4134
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 979-4134
(423) 979-4134
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD42438
TN
207RI0011X
Interventional Cardiology Physician
Primary
MD42438
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD0000042438
MEDICAL LISCENCE
TN
Enumeration date
10/15/2007
Last updated
02/01/2019
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