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Contact Information

HOLSTON PEDIATRIC AND ADOLESCENT CARE
698 CLINCHFIELD ST
KINGSPORT, TN37660-3630
 Phone: 423-378-6202
 Fax: 423-246-8907
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for HOLSTON PEDIATRIC AND ADOLESCENT CARE

NPI # 1285723585
LBN Legal business name HOLSTON PEDIATRIC AND ADOLESCENT CARE
Authorized official JOSEPH MORIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2006
Last updated 06/17/2008 - About 18 years ago
Identifiers
TN License # MD0000011946
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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