Individual
DR. CHAMBLESS RAND JOHNSTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2408 SUSANNAH ST, JOHNSON CITY, TN 37601-1732
(423) 434-6677
(423) 461-0000
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101246390
VA
207R00000X
Internal Medicine Physician
Primary
45404
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528827
—
TN
05
—
1790972628
—
NC
05
—
1790972628
—
VA
01
—
P01037769
RR MEDICARE
TN
Enumeration date
09/25/2007
Last updated
09/18/2023
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