Individual
CONNIE R STOOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 MED TECH PKWY STE 120, JOHNSON CITY, TN 37604
(423) 794-5590
(423) 794-5877
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5590
(423) 794-5877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44523
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512854
—
TN
Enumeration date
08/26/2007
Last updated
02/21/2025
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