| City Of Kingsport | |
|
415 Broad St Ste 644 Kingsport TN 37660-4207 | |
| (423) 343-9851 | |
| (423) 343-9851 |
| Full Name | City Of Kingsport |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 415 Broad St Ste 644, Kingsport, Tennessee |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of Kingsport 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | City Of Kingsport 415 Broad St Ste 644 Kingsport TN 37660-4207 Ph: (423) 343-9851 |
| NPI Number | 1215500483 |
|---|---|
| Provider Enumeration Date | 07/23/2021 |
| Last Update Date | 09/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215500483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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