Individual
DR. JOHN ALBERT EHRENFRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 W RAVINE RD STE 3A, KINGSPORT, TN 37660-3841
(423) 245-6101
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD34462
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007311095
—
VA
05
—
3046047
—
TN
01
—
3151526
BLUE CROSS TENNESSEE
TN
01
—
382329
ANTHEM VIRGINIA BCBS
VA
01
—
910000313
MEDICARE RAILROAD
TN
Enumeration date
11/07/2006
Last updated
08/27/2024
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