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Dr. Fredric R Mishkin

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NPI Number Detailed Information

Provider Information:

Name: Dr. Fredric R Mishkin
Gender: M
Provider License Number If Given: MD19796

NPI Information:

NPI: 1134114614
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 5/23/2008

Provider Business Mailing Address:

Address: 135 W RAVINE RD SUITE 3A
Kingsport, TN 37660
Phone Number: 4232466777
Fax Number: 4232467766

Provider Business Practice Location Address:

Address: 135 W RAVINE RD SUITE 3A
Kingsport, TN 37660
Phone Number: 4232466777
Fax Number: 4232467766

Provider Taxonomy:

Primary: 207RG0100X
Secondary (if any):
State: TN

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