Provider Demographics
NPI:1740563220
Name:APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Entity Type:Organization
Organization Name:APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-239-1550
Mailing Address - Street 1:4105 FORT HENRY DR
Mailing Address - Street 2:STE 300
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2240
Mailing Address - Country:US
Mailing Address - Phone:423-239-1550
Mailing Address - Fax:423-239-1544
Practice Address - Street 1:1600 JOHNSTON MEMORIAL DRIVE
Practice Address - Street 2:STE. 100
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211
Practice Address - Country:US
Practice Address - Phone:276-477-1443
Practice Address - Fax:276-477-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9826Medicare PIN