Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 43463 | TN |
NPI | 1003034851 |
---|---|
Provider Name | Dr. Amy Lynn Gust |
First Address | Knoxville, TN 37909-2604 |
Second Address | Sevierville, TN 37862-5014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 23/06/2011 |