Organization
EAST TENNESSEE ADDICTION SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY EUGENE STALCUP MD (CO-OWNER)
(865) 406-2715
Entity
Organization
Contact information
Practice address
20445 ALBERTA ST, ONEIDA, TN 37841-3509
(423) 286-7638
Mailing address
2036 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 268-4360
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q045176
—
TN
Enumeration date
12/13/2023
Last updated
01/23/2024
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