OrganizationActive
East Tennessee State University
NPI 1093990608 · Federally Qualified Health Center (FQHC) · Johnson City, TN
Provider details
- NPI number
- 1093990608
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Betty King, Acting Chief Financial Officer(423) 439-4414
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
202 W Fairview Ave
Johnson City, TN 37604-5611
Phone: (423) 434-0894
Fax: (423) 434-0666
Approximate (ZIP-level) locationGet directions
Mailing address
365 Stout Drive Box 70403
Johnson City, TN 37614-1703
Other names (DBA / former)
- Doing business as
- Johnson City Downtown Clinic Day Center
Registry dates
- Enumerated
- 2008-01-02
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.