ADVANCED MEDICAL GROUP NPI 1205167509

NPI Information

ADVANCED MEDICAL GROUP is a general practice in Maryville, TN. ADVANCED MEDICAL GROUP NPI is 1205167509. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Foothills Pain Management.

The provider's business location address is:

717 WATKINS RD
MARYVILLE, TN
ZIP 37801-598
Phone: (865) 980-7802
Fax: (865) 980-7804

The provider's authorized official is Terry Bragg .
The authorized official title is President and has the following contact phone number (865) 982-7802.

The enumeration date for this NPI number is 1/26/2010 and was last updated on 1/26/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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