Mountain States Health Alliance

Pediatrics

Mountain States Health Alliance is a Johnson City, Tennessee based Pediatric center with medical specialization in General Pediatrics. It is located at 400 N State Of Franklin Rd, Niswonger Children's Hospital Admin, Johnson City, Tennessee - 37604-6035. They can be contacted on phone at 423-431-4847 and fax number 423-431-3949.
NPI number (Unique professional ID) for Mountain States Health Alliance is 1124426259 which was assigned by NPPES on 05 Dec, 2014 and it was last updated on 26 Feb, 2018.
Mountain States Health Alliance is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Mountain States Health Alliance basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
Specialization :Pediatrics
Provider Name :Mountain States Health Alliance
Business Address:
Mountain States Health Alliance address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Primary Address :400 N State Of Franklin Rd, Niswonger Children's Hospital Admin
Johnson City, TN, 37604-6035
United States
Phone Number :423-431-4847
Fax Number :423-431-3949
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number : 1124426259
NPI Entity Type : Organization
First Enrolment Date : 05 Dec, 2014
Last Updated On : 26 Feb, 2018
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
Authorized Official Name :Marylynn Krutak
Official Title or Position :EVP/CFO
Phone Number :423-302-3423
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mountain States Health Alliance are as mentioned. Primary taxonomy code for Mountain States Health Alliance is 208000000X (Pediatrics).
Taxonomy Code SpecialityPrimaryLicense No.State
208000000XPediatricsYes
2080P0203XPediatrics Pediatric Critical Care MedicineNo
363LP0200XNurse Practitioner PediatricsNo
Legacy Identifiers:
Other legacy medical identifiers of Mountain States Health Alliance such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
IdentifierIdentifier TypeStateIssuer
Q010765MEDICAIDTN
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
Mailing Address :311 Princeton Rd Ste 1
Johnson City, TN, 37601-2026
United States
Phone Number :423-431-4847
Fax Number :423-431-3949
Business Location:
Patients can refer following map for directions to Mountain States Health Alliance practice address. Don't forget to take prior appointment before visiting.

** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.