Organization · Type 2 NPI

East Tennessee State University

Federally Qualified Health Center (FQHC) · Johnson City, TN

NPI number 1477660199 Active

Practice location

2151 Century Lane
Johnson City, TN 37604

Fax (423) 926-5999

Mailing address

365 Stout Drive, Box 70403
Johnson City, TN 37614-1703

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

10 other providers at this address

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About NPI 1477660199

East Tennessee State University's National Provider Identifier is 1477660199, issued on Aug 25, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Johnson City, TN. The record was last updated on Jul 21, 2022.