Provider Demographics
NPI:1598750481
Name:GARCIA, ISRAEL D (MD)
Entity Type:Individual
Prefix:
First Name:ISRAEL
Middle Name:D
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N STATE OF FRANKLIN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6008
Mailing Address - Country:US
Mailing Address - Phone:423-979-6000
Mailing Address - Fax:423-979-6011
Practice Address - Street 1:310 N STATE OF FRANKLIN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6008
Practice Address - Country:US
Practice Address - Phone:423-979-6000
Practice Address - Fax:423-979-6011
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN37665207R00000X
TNMD37665207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004509824OtherAETNA
TNP01437956OtherRAILROAD MEDICARE
KY64125214Medicaid
VA1598750481Medicaid
TN4103496OtherBLUE CROSS BLUE SHIELD
TN3327335Medicaid
8519292OtherCIGNA
TNTN0121OtherUNITED HEALTHCARE OF THE
P00216836OtherRAILROAD MEDICARE
VA5901177Medicaid
NC196436OtherMEDCOST
VA010143098Medicaid
KY64125214Medicaid
TN3327335Medicare PIN
P00216836OtherRAILROAD MEDICARE
TN3327335Medicaid