Organization
ELAINE L. DEVOS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE L DEVOS MD (PRESIDENT)
(423) 854-9051
Entity
Organization
Contact information
Practice address
2511 WESLEY ST, JOHNSON CITY, TN 37601-1723
(423) 854-9051
Mailing address
2817 AVONDALE DR, JOHNSON CITY, TN 37604-1900
(423) 854-9051
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
MD28462
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3040644
BLUE CROSS
TN
05
—
3805386
—
TN
Enumeration date
04/29/2008
Last updated
12/08/2009
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