Watauga Lake Family Medicine PC
Organization Active NPI Family Medicine Physician · Butler, TN
NPI 1457548406 · NPPES record last updated Oct 3, 2007
Key facts
- NPI
- 1457548406
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD0000041068 (TN)
- Legal business name
- WATAUGA LAKE FAMILY MEDICINE PC
- Practice address
- 140 McQueen St.
Butler, TN 37640 - Phone
- (423) 768-0195
- NPI assigned
- Oct 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Amy R. Miller
- Title
- Business Manager
- Phone
- (336) 982-2158
Practitioners 5
-
Barbara Hathaway, APN
-
Lisa Ousley, DNP
-
Henry Tucker Clay Jr., M.D.
National Provider Directory
Locations
138 N Fork New River Rd
Lansing, NC 28643
Phone (336) 982-1813
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MD0000041068 | TN | Yes |
Addresses
Primary practice location
140 McQueen St.
Butler, TN 37640
Mailing address
138 N Fork New River Rd
Lansing, NC 28643-9130
Phone (336) 982-2158
Other providers in Butler, TN
All providers in Butler, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.