Provider Demographics
NPI:1356611305
Name:NOLICHUCKEY MANAGEMENT SERVICES, INC.
Entity type:Organization
Organization Name:NOLICHUCKEY MANAGEMENT SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-787-5077
Mailing Address - Street 1:2020 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4633
Mailing Address - Country:US
Mailing Address - Phone:423-343-0434
Mailing Address - Fax:423-343-0435
Practice Address - Street 1:1410 TUSCULUM BLVD
Practice Address - Street 2:SUITE 1700
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4286
Practice Address - Country:US
Practice Address - Phone:423-787-7100
Practice Address - Fax:423-787-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty