Mishkin, Fredric R

Mishkin, Fredric R is an individual health care provider with primary practice located at 135 W Ravine Rd Suite 3A, Kingsport TN 37660-3847. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mishkin, Fredric R can be contacted via phone (423) 246-6777.

Contact Information

Primary practice address
135 W Ravine Rd Suite 3A Kingsport TN 37660-3847
Phone: (423) 246-6777
Fax: (423) 246-7766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD19796 Tennessee

Profile Details

NPI number 1134114614
LBN Legal business name Mishkin, Fredric R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated May 23rd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134114614 NPPES
Virginia MEDICAID 006025552
Virginia Other 057653
Virginia Other 100010463
Virginia MEDICAID 1803461000
Virginia MEDICAID 64794654
Virginia Other 000000053385
Virginia Other 4675304
Virginia Other TN0103
Virginia MEDICAID 3700033
Virginia Other 000127737

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