Individual
DR. GEOFFREY GRATTAN CORRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 MEADOWVIEW RD, SUITE 3, BRISTOL, TN 37620-1669
(423) 968-2446
(423) 968-7223
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101054051
VA
207Q00000X
Family Medicine Physician
Primary
MD27152
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005600227
—
VA
Enumeration date
01/25/2006
Last updated
04/29/2013
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