Organization
KINGSPORT PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY F LANE CCP-P (PRACTICE ADMINISTRATOR)
(423) 245-8400
Entity
Organization
Contact information
Practice address
2012 BROOKSIDE DR, SUITE 1, KINGSPORT, TN 37660-4645
(423) 245-8400
(423) 245-9959
Mailing address
2012 BROOKSIDE DR, SUITE 1, KINGSPORT, TN 37660-4645
(423) 245-8400
(423) 245-9959
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
25312
TN
Other
Enumeration date
03/14/2008
Last updated
03/14/2008
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