Healthcare Provider Details

I. General information

NPI: 1518463561
Provider Name (Legal Business Name): TERRANCE CARL NOWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY # U-109
KNOXVILLE TN
37920-6900
US

IV. Provider business mailing address

1924 ALCOA HWY # U-109
KNOXVILLE TN
37920-6900
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9220
  • Fax: 865-305-9216
Mailing address:
  • Phone: 865-305-9220
  • Fax: 865-305-9216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number0000060107
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0000060107
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: