Look up the most recent NPI and PECOS records

Edward Monty Stirman

Family Medicine

Allopathic & Osteopathic Physicians

105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3256

(423) 323-6200 (423) 857-2066

PECOS Enrollment

Based on the most recent information from CMS, provider Edward Monty Stirman does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 4:18 PM.

Profile Details

Provider ID
1043213994
Provider Type
Individual
Full Name
Stirman, Edward Monty
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/24/2005
Last Updated
9/23/2009

Contact Information

Practice Location

105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3256

(423) 323-6200

(423) 323-6593

Mailing Location

PO Box 9, Kingsport, TN 37662-0009

(423) 857-2066

(423) 857-2070

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License MD 11282 Tennessee
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 0101030270 Virginia

Provider Identifiers

ID	Description	Issuer
ID 5610265	Description Medicaid	Issuer Unlisted Virginia
ID 3172037	Description Medicaid	Issuer Unlisted Tennessee

Edward Monty Stirman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Blue Ridge Medical Management Corporation

Cooper, Carli J

Metcalf, Aaron K

Hubbs, Emily

Hixson, Constance Thetford

Fox, Beth Anne

Becker, Mary Elizabeth

Kauzlarich, Michael P

Kliesch, John F

Tochev, Tihomir Ivanov