MMDS Idtf LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MMDS IDTF LLC

Practice address

1038 S Wilcox Dr
Suite 115
Kingsport, TN 37660-5378

Phone

(423) 230-8093

NPI assigned

May 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lloyd Williams

Title

Director

Phone

(423) 230-8093

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629020896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15268",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288130268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 S WILCOX DR",
            "address_2": "SUITE 115",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605378",
            "telephone_number": "423-230-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMDS IDTF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-230-8093"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Mitchell, MD
• Dana Mitchell
• Kristina Elizabeth Mitchem, CRNA
• Amy E. Mize, LPE
• Howard Mize Jr., M.D.
• MMDS of Kingsport, LLC
• MMDS, LLC (Stat Xrays)
• Eric David Moffet, MD
• Jennifer Leigh Mongold, MA
• Amy R Monroe, DPT

• Physiological Laboratory in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physiological Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.