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:
Map and Directions
Authorized official contact:
Name: Wiles, David A. Doctor of Medicine (MD)
Phone: (423) 232-8301

Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
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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