Organization
TRI-CITY PEDIACTRIC CARDIOLOGY P C
Active
Other names
TRI-CITY PEDIACTRIC CARDIOLOGY P C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHOK V MEHTA MD (PRESIDENT AND CEO)
(423) 610-1099
Entity
Organization
Contact information
Practice address
2312 KNOB CREEK RD, SUITE 208, JOHNSON CITY, TN 37604-2367
(423) 610-1099
(423) 610-1166
Mailing address
PO BOX 3953, JOHNSON CITY, TN 37602-3953
(423) 610-1099
(423) 610-1166
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3722336
—
TN
Enumeration date
11/15/2006
Last updated
04/06/2012
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