GRACE INTERNAL MEDICINE LLC NPI 1841741196

NPI Information

NPI: 1841741196
Provider Name: GRACE INTERNAL MEDICINE, LLC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
2514 WESLEY ST
SUITE 102
JOHNSON CITY, TN
ZIP 37601
Phone: (423) 282-2700
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GRACE INTERNAL MEDICINE, LLC is a medical physician assistant in Johnson City, TN. GRACE INTERNAL MEDICINE, LLC NPI is 1841741196. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2514 WESLEY ST
SUITE 102
JOHNSON CITY, TN
ZIP 37601-764
Phone: (423) 282-2700
Fax: (423) 282-2802

The provider's authorized official is Whitney Diana Davis .
The authorized official title is Physician Assistant/owner and has the following contact phone number (423) 282-2700.

The enumeration date for this NPI number is 10/21/2016 and was last updated on 10/21/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	2497	TENNESSEE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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