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102 N Broadway St Johnson City TN 37601-3525 | |
(423) 588-9978 | |
(423) 722-3401 |
Full Name | |
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Speciality | Family Medicine - Addiction Medicine |
Location | 102 N Broadway St, Johnson City, Tennessee |
Authorized Official Name and Position | Matthew John Caffrey (MEDICAL DIRECTOR) |
Authorized Official Contact | 4235889978 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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216 Quail Run Ct Johnson City TN 37601-5364 Ph: (423) 525-7488 | 102 N Broadway St Johnson City TN 37601-3525 Ph: (423) 588-9978 |
NPI Number | 1689134231 |
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Provider Enumeration Date | 03/20/2019 |
Last Update Date | 09/30/2019 |
Identifier | Type | State | Issuer |
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1689134231 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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