Individual
DR. JOHN SCOTT GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2328 KNOB CREEK RD, SUITE 506, JOHNSON CITY, TN 37604-2100
(423) 722-1311
(423) 926-0529
Mailing address
2328 KNOB CREEK RD, SUITE 506, JOHNSON CITY, TN 37604-2100
(423) 722-1311
(423) 926-0529
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
827
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3596084
DMERC
TN
01
—
48046
BLUE CROSS BLUE SHIELD
TN
Enumeration date
05/25/2006
Last updated
11/23/2015
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