Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Allergy and Medical Clinic, Inc

Organization Allergy Physician · NPI 1417513177

Southern Allergy and Medical Clinic, Inc is an Allergy Physician in New Tazewell, Tennessee. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

109 Main St
New Tazewell, TN 37825-6635
Phone: (423) 259-5704
Fax: (423) 259-5706
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy Physician (primary) Taxonomy 207KA0200X
Primary Care Clinic/Center Taxonomy 261QP2300X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1417513177
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sasha Bussell — Owner · (423) 489-5841
NPI enumeratedMay 17, 2019
Last updated in NPPESMay 17, 2019
Mailing addressPo Box 69, New Tazewell, TN 37824-0069