East Tennessee State University
East Tennessee State University is a Family Medicine Physician in Johnson City, Tennessee. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
1081 John Robert Bell Dr Rm W-127Johnson City, TN 37614
Phone: (972) 367-4845
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|
Record details
| NPI number | 1285264531 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mouzon Bass — Administrator/Agent · (972) 367-4845 |
| Other names | Etsu Sports Medicine; Etsu Sports Medicine |
| NPI enumerated | January 24, 2020 |
| Last updated in NPPES | December 17, 2021 |
| Certification date | December 17, 2021 |
| Mailing address | 15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415 |
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Dr. Jeremy Nathan Elliott, DO
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Dr. David Keith Emerine, DO
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Ashlyn Fadial
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