Organization
MEDICAL DIAGNOSTIC SERVICES,LLC
Active
Other names
MMDS International
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M SMITH (VICE PRESIDENT)
(423) 863-0827
Entity
Organization
Contact information
Practice address
2005 VENTURE PARK, STE 21, KINGSPORT, TN 37660-1098
(423) 863-0827
Mailing address
2005 VENTURE PARK, STE 21, KINGSPORT, TN 37660-1098
(423) 863-0827
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3403932
TRICARE FOR LIFE
TN
05
—
3403932A
—
TN
05
—
3409803
—
NC
01
—
4056127
BCBS OF TENNESSEE
TN
Enumeration date
06/09/2005
Last updated
08/22/2020
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