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Lake Dr., Bldg. 52 Mountain Home TN 37684-0699 | |
(423) 439-8000 | |
(423) 433-2200 |
Full Name | |
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Speciality | Psychiatry & Neurology - Psychiatry |
Location | Lake Dr., Bldg. 52, Mountain Home, Tennessee |
Authorized Official Name and Position | Russell E Lewis (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4234336050 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2204 Johnson City TN 37605-2204 Ph: (423) 433-6050 | Lake Dr., Bldg. 52 Mountain Home TN 37684-0699 Ph: (423) 439-8000 |
NPI Number | 1518236538 |
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Provider Enumeration Date | 12/20/2011 |
Last Update Date | 12/20/2011 |
Identifier | Type | State | Issuer |
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1518236538 | NPI | - | NPPES |