Individual provider · Type 1 NPI

Huntter Ollie, Eugene Spencer

Surgical Physician Assistant · Johnson City, TN

NPI number 1861295628 Active

Practice location

410 N State Of Franklin Rd Ste 130
Johnson City, TN 37604-6972

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192

Other practice locations

  • 133 Boone Ridge Dr Apt 169, Johnson City, TN 37615-5023 · (662) 288-0224

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X6617 (TN)
Physician Assistant 363A00000X6617 (TN)

Surgical Physician Assistant: Definition to come...

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About NPI 1861295628

Huntter Ollie, Eugene Spencer's National Provider Identifier is 1861295628, issued on Mar 28, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Johnson City, TN. The record was last updated on Sep 8, 2025.