East Tennessee Brain & Spine Center, Pc
LBN: East Tennessee Brain & Spine Center, Pc
East Tennessee Brain & Spine Center, Pc is an health care organization with primary practice located at 701 Med Tech Pkwy Suite 300, Johnson City TN 37604-2365. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Neurological Surgery is the primary health care specialty.
East Tennessee Brain & Spine Center, Pc can be contacted via phone (423) 232-8301, or through Wiles, David A. via phone (423) 232-8301.
Contact Information
Primary practice address
701 Med Tech Pkwy Suite 300
Johnson City TN 37604-2365
Phone: (423) 232-8301
Fax: (423) 232-8304
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | Tennessee | |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | Tennessee | |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X |
Profile Details
| NPI number | 1366452914 |
|---|---|
| LBN Legal business name | East Tennessee Brain & Spine Center, Pc |
| DBA Doing business as | |
| Authorized official | Wiles, David A. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Jun 6th, 2012 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366452914 | NPPES |
| Tennessee | Other | 4069221 | BLUE CROSS/BLUE SHIELD |
| Tennessee | MEDICAID | 3721061 | BLUE CROSS/BLUE SHIELD |
| Tennessee | MEDICAID | 1366452914 | BLUE CROSS/BLUE SHIELD |
| Tennessee | MEDICAID | 5903904 | BLUE CROSS/BLUE SHIELD |
| Tennessee | MEDICAID | 7100132610 | BLUE CROSS/BLUE SHIELD |
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