Organization
WELLMONT PHYSICIAN SERVICES INC
Active
Other names
Regional Orthopaedic Traumatology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY M LOCKE (BILLING ADMINISTRATOR)
(423) 224-3250
Entity
Organization
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 224-3210
(423) 224-3215
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 230-8281
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098710002
DMERC
TN
Enumeration date
01/10/2007
Last updated
10/25/2007
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