Id Micro PLLC
Organization Active NPI Infectious Disease Physician · Kingsport, TN
NPI 1477598076 · NPPES record last updated Jan 24, 2012
Key facts
- NPI
- 1477598076
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- MD38189 (TN)
- Legal business name
- ID MICRO PLLC
- Practice address
- 130 W Ravine Rd
Kingsport, TN 37660-3837 - Phone
- (423) 915-1126
- NPI assigned
- Jun 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Anton Maki Jr., MD
- Title
- Owner
- Phone
- (423) 915-1126
Practitioners 1
-
Keith G Porter, MD
National Provider Directory
Locations
146 W Park Dr
Ste 9C
Kingsport, TN 37660
Phone (423) 224-3450
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | MD38189 | TN | Yes |
Addresses
Primary practice location
130 W Ravine Rd
Kingsport, TN 37660-3837
Mailing address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 915-1126
Other providers in Kingsport, TN
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- Savannah Faith Hutson
- Rita Dawn Hutton
- Vickie Hyder
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All providers in Kingsport, TN · Infectious Disease 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 Jan 24, 2012. 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.