Bobby Gene Ewing, PH.D.
Individual provider Active NPI Clinical Psychologist · Jonesborough, TN
NPI 1457564676 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457564676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 00001566 (TN)
- Practice address
- 314 Jim Range Rd
Jonesborough, TN 37659-5904 - Phone
- (423) 753-0357
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00001566 | TN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00001566 | TN | Yes |
Addresses
Primary practice location
314 Jim Range Rd
Jonesborough, TN 37659-5904
Mailing address
314 Jim Range Rd
Jonesborough, TN 37659-5904
Phone (423) 753-0357
Other providers in Jonesborough, TN
- Sydney Emore
- Enclavejoy LLC
- Ashlie B Epling
- Alice Erickson
- Sloane Deluke Eusebio
- John Ewing III
- Family Medicine of Jonesborough LLC
- Fast Pace Medical Clinic PLLC
- Shannon Fee
- Martha Lynn Fleming
All providers in Jonesborough, TN · Clinical Psychologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 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.