Healthcare Provider Details

I. General information

NPI: 1215126412
Provider Name (Legal Business Name): SUMMIT MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date: 08/25/2008
Reactivation Date: 10/19/2010

III. Provider practice location address

10820 KINGSTON PIKE SUITE 11
FARRAGUT TN
37934-3066
US

IV. Provider business mailing address

1225 E WEISGARBER RD SUITE 200
KNOXVILLE TN
37909-2604
US

V. Phone/Fax

Practice location:
  • Phone: 865-671-6720
  • Fax: 865-671-6771
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-584-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ED CURTIS
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 865-584-4747