Organization
TRI-CITIES PEDIATRIC ENDOCRINOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY GWYN ROPER M.D., F.A.A.P. (OWNER)
(423) 483-0828
Entity
Organization
Contact information
Practice address
140 OLD GRAY STATION RD, SUITE 200, GRAY, TN 37615-3612
(423) 483-0828
(423) 546-4103
Mailing address
PO BOX 3343, JOHNSON CITY, TN 37602-3343
(423) 483-0828
(423) 546-4103
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
37128
TN
Other
Enumeration date
11/19/2013
Last updated
02/05/2015
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