Organization
TRI STATE MOUNTAIN NEUROLOGY ASSOCIATES PC
Active
Other names
Neurology Associates of Johnson City PC
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL R WHALEY MD (SECRETARY)
(423) 928-6174
Entity
Organization
Contact information
Practice address
1321 SUNSET DRIVE, SUITE 11, JOHNSON CITY, TN 37604-7902
(423) 928-6174
(423) 926-2258
Mailing address
1321 SUNSET DRIVE, SUITE 11, JOHNSON CITY, TN 37604-7902
(423) 928-6174
(423) 926-2258
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009788
BCBS
TN
01
—
164888600
OWCP
—
05
—
3380796
—
TN
Enumeration date
06/27/2006
Last updated
10/16/2024
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