Provider Demographics
NPI:1669940078
Name:APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Entity type:Organization
Organization Name:APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOO
Authorized Official - Prefix:
Authorized Official - First Name:DARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-239-1550
Mailing Address - Street 1:4105 FORT HENRY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2256
Mailing Address - Country:US
Mailing Address - Phone:423-239-1538
Mailing Address - Fax:423-239-1544
Practice Address - Street 1:4221 FORT HENRY DR
Practice Address - Street 2:SUITE 1
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2227
Practice Address - Country:US
Practice Address - Phone:423-239-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-05
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty