Healthcare Provider Details

I. General information

NPI: 1497740757
Provider Name (Legal Business Name): COMPLETE SURGICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 WESTLAND DR SUITE 101
KNOXVILLE TN
37922-5294
US

IV. Provider business mailing address

6701 BAUM DR SUITE 140
KNOXVILLE TN
37919-7360
US

V. Phone/Fax

Practice location:
  • Phone: 865-934-6080
  • Fax: 865-934-6081
Mailing address:
  • Phone: 865-584-5727
  • Fax: 865-450-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAREN E GALLAHER
Title or Position: OWNER
Credential:
Phone: 865-934-6080