Graduated: 2017
NPI: 1134638604
Practice Locations (2)
SOUTHEASTERN PHYSICIAN SERVICES PC
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 376046035
4234316111
HOLSTON MEDICAL GROUP PC
105 W STONE DR
KINGSPORT, TN 376603365
4238572793
Source: CMS National Downloadable File, September 2026.