Graduated: 2010
NPI: 1831478411
Practice Locations (2)
SOUTHEASTERN PHYSICIAN SERVICES PC
300 MED TECH PKWY
JOHNSON CITY, TN 376042277
4233021000
SOUTHEASTERN PHYSICIAN SERVICES PC
1201 BISHOP ST
UNION CITY, TN 382615403
7318852410
Source: CMS National Downloadable File, September 2026.