Kingsport Primary Healthcare, LLC

NPI #1679074892 in Kingsport, Tennessee

Provider Information

NPI Number: 1679074892
Entity Type: Organization
Organization Name: Kingsport Primary Healthcare, LLC
Primary Specialty: Family Medicine
Enumeration Date: Feb 22, 2018
Last Updated: Feb 22, 2018

Practice Location

Address: 1526 BRIDGEWATER LN
City: Kingsport
State: Tennessee
ZIP Code: 37660-4106
Phone: (423) 246-0033

Authorized Official

Name: STAN MCLAIN, MD
Title: MEDICAL DIRECTOR
Phone: (313) 363-6325

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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