Organization
TRI STATE MOUNTAIN NEUROLOGY ASSOCIATES PC
Active
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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