OrganizationActive
East Tennessee State University
NPI 1982905576 · Federally Qualified Health Center (FQHC) · Johnson City, TN
Provider details
- NPI number
- 1982905576
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Authorized official
- Betty King, Acting Chief Financial Officer
Practice location
1134-1136 E. Main Street
Johnson City, TN 37601
Phone: (423) 722-0808
Fax: (423) 929-2930
Mailing address
365 Stout Drive Box 70403
Johnson City, TN 37614-1703
Registry dates
- Enumerated
- 2010-11-12
- 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.