| |
2435 Jacksboro Pike Ste 3, La Follette, TN 37766-2912 | |
(423) 449-8135 | |
(423) 201-9559 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 2435 Jacksboro Pike Ste 3, La Follette, Tennessee |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649757238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | DPM739 (Tennessee) | Primary |
Mailing Address | Practice Location Address |
---|---|
2435 Jacksboro Pike Ste 3, La Follette, TN 37766-2912 Ph: (423) 449-8135 | 2435 Jacksboro Pike Ste 3, La Follette, TN 37766-2912 Ph: (423) 449-8135 |