| Organization Name: | MOUNTAIN MEDICAL SERVICES PLLC |
| NPI Number: | 1053610717 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROGER DALE BARNES (DOCTOR) |
| Mailing Address: | 2946 Winfield Dunn Pkwy Ste 107 Kodak |
| State: | TN US |
| Postal Code: | 377644306 |
| Phone Number: | 8659339950 |
| Fax Number: | 8654653937 |
| NPI Enumeration Date: | 03/21/2011 |
| NPI Last Update Date: | 06/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APN 13355 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |