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EAST TENNESSEE MEDICAL AND SURGICAL DERMATOLOGY
NPI 1356975106
Clinic/Center - Medical Specialty in Johnson City, TN

Active since March 02, 2020
2898 BOONES CREEK RD STE 105, JOHNSON CITY, TN 37615(423) 262-0112 Get Directions Write a Review

NPPES record last updated: July 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 15, 2020, Mar 2, 2020 (2 updates tracked since 2020).

About East Tennessee Medical And Surgical Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST TENNESSEE MEDICAL AND SURGICAL DERMATOLOGY (NPI 1356975106) is a healthcare organization registered as a medical specialty in Johnson City, Tennessee and active in the NPI registry since March 2020. The organization lists Stuart S Leicht, Physician, as its authorized official.

NPPES Registry Identity

NPI1356975106
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameEAST TENNESSEE MEDICAL AND SURGICAL DERMATOLOGY
Location Address2898 BOONES CREEK RD STE 105Johnson City, TN 37615-4976
Mailing Address2898 Boones Creek Rd Ste 105Johnson City, TN 37615-4976 · (423) 262-0112 · Fax (423) 433-6060
Phone(423) 262-0112
Organization SubpartNo
Authorized OfficialStuart S LeichtPhysician · (423) 262-0112
Enumeration DateMarch 2, 2020
Last NPPES UpdateJuly 15, 20202 updates tracked since enumeration
NPPES CertifiedJuly 15, 2020
✔ NPI 1356975106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
2898 BOONES CREEK RD STE 105, Johnson City, TN 37615
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUART S LEICHT M.D.
Dermatology
2898 BOONES CREEK RD STE 105
JOHNSON CITY, TN 37615
Washington County (423) 262-0112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Tennessee Medical And Surgical Dermatology's NPI number?

The NPI number for East Tennessee Medical And Surgical Dermatology is 1356975106. It was assigned to this organization in the NPPES registry on March 2, 2020.

Where is East Tennessee Medical And Surgical Dermatology located?

East Tennessee Medical And Surgical Dermatology is located at 2898 Boones Creek Rd Ste 105, Johnson City, TN 37615. The listed phone number is (423) 262-0112.

What is East Tennessee Medical And Surgical Dermatology's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for East Tennessee Medical And Surgical Dermatology was last updated on July 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.