Organization
TAKOMA REGIONAL HOSPITAL, INC.
Active
Parent organization
TAKOMA REGIONAL HOSPITAL, INC.
Other names
Ballad Health Medical Associates, Kids First Pediatrics of NE TN
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAKOMA REGIONAL HOSPITAL, INC.
Authorized official
GREGORY LEE WILGOCKI (VP REIMBURSEMENT)
(423) 431-5794
Entity
Organization
Contact information
Practice address
5000 MONARCH PT, GREENEVILLE, TN 37745-4275
(423) 798-6630
Mailing address
105 W STONE DR STE 6A, KINGSPORT, TN 37660-3256
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/22/2015
Last updated
02/20/2019
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