Provider Demographics
NPI:1629002043
Name:COUNTS, MARC D (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:D
Last Name:COUNTS
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 1:2050 MEADOWVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7475
Mailing Address - Country:US
Mailing Address - Phone:423-230-5000
Mailing Address - Fax:423-390-6852
Practice Address - Street 1:2050 MEADOWVIEW PKWY
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7475
Practice Address - Country:US
Practice Address - Phone:423-230-5000
Practice Address - Fax:423-390-6852
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235404207RC0000X
TN31853207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010224896Medicaid
VA178745OtherANTHEM
TN3373123Medicaid
TN4105714OtherBCBS
NC5900978Medicaid
TNTN0109OtherJOHN DEERE HEALTH
KY65943904Medicaid
TNTN0109OtherJOHN DEERE HEALTH
TN3373123Medicaid
NC5900978Medicaid
VA010224896Medicaid