Healthcare Provider Details

I. General information

NPI: 1932149127
Provider Name (Legal Business Name): DAVID SEAN NEWPORT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8874 KINGSTON PIKE
KNOXVILLE TN
37923-5010
US

IV. Provider business mailing address

8874 KINGSTON PIKE
KNOXVILLE TN
37923-5010
US

V. Phone/Fax

Practice location:
  • Phone: 865-690-4200
  • Fax: 865-531-9018
Mailing address:
  • Phone: 865-690-4200
  • Fax: 865-531-9018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC0000001178
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: