Individual
MARK W EMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Mailing address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
19732
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006040209
VIRGINIA MEDICAID
VA
01
—
0094319
BLUE CROSS BLUE SHIELD
TN
01
—
065196
ANTHEM
VA
01
—
100023382
PHP TENN CARE
TN
05
—
1000908
—
TN
01
—
1736855
UNITED HEALTHCARE
TN
05
—
3047487
—
TN
01
—
5141032
AETNA
TN
01
—
62134825601
JOHN DEERE HEALTHCARE
TN
01
—
64798580
KENTUCKY MEDICAID
KY
05
—
65906208
—
KY
01
—
Z101
UNITED HEALTHCARE OF THE RIVER VALLEY
TN
Enumeration date
05/19/2006
Last updated
08/06/2012
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