Mary Axelrad
Family Doctor
4848 Fort Henry Dr
Kingsport
, Tennessee 37663-3347
Mary Axelrad
Family Doctor
4848 Fort Henry Dr
Kingsport
, Tennessee 37663-3347
(423) 390-3340
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Mary Axelrad
- Po Box 9
- Kingsport, TN
- Zip : 37662-0009
- Fax : (423) 390-3340
- Phone : (423) 857-2093
Second Address
- Mary Axelrad
- 4848 Fort Henry Dr
- Kingsport, TN
- Zip : 37663-3347
- Fax : (423) 239-4869
- Phone : (423) 239-5141
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 58418 | TN |
National Provider Identifier
| NPI | 1003278672 |
|---|---|
| Provider Name | Mary Axelrad |
| First Address | Kingsport, TN 37662-0009 |
| Second Address | Kingsport, TN 37663-3347 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/03/2016 |
| Last Update Date | 21/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.