Healthcare Provider Details

I. General information

NPI: 1033447008
Provider Name (Legal Business Name): FAMILYCARE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2009
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E WEISGARBER RD SUITE 101
KNOXVILLE TN
37909-2685
US

IV. Provider business mailing address

PO BOX 52268
KNOXVILLE TN
37950-2268
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-1054
  • Fax: 865-588-8350
Mailing address:
  • Phone: 865-584-2146
  • Fax: 865-584-9660

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: KIM WHITE
Title or Position: ADMINISTRATOR
Credential:
Phone: 865-584-2146