NPI 1093580466
Mountain States Health Alliance
Practice location
- Address
- 1 Professional Park Dr STE 21, Johnson City, TN 37604-6909
- Phone
- (423) 232-6900
- Fax
- (423) 232-6903
- Mailing address
- 1021 W Oakland Ave STE 310, Johnson City, TN 37604-2192
Authorised official
- Name
- Patricia Tarte
- Title
- Enrollment Supervisor
- Phone
- (423) 302-6565
Registered specialties
Hematology & Oncology Physician
Primary
Registry record
- NPI
- 1093580466
- Entity type
- Organization
- NPI issued
- 16 Nov 2023
- Record last updated
- 16 Nov 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.