Organization
TRI-STATE CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY A SEXTON (BUSINESS OFFICE MANAGER)
(423) 282-5054
Entity
Organization
Contact information
Practice address
2408 SUSANNAH ST, STE.1, JOHNSON CITY, TN 37601-1728
(423) 282-5054
(423) 262-0220
Mailing address
2408 SUSANNAH ST, STE.1, JOHNSON CITY, TN 37601-1728
(423) 282-5054
(423) 262-0220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4058472
BCBS
TN
Enumeration date
07/17/2006
Last updated
08/22/2020
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