Healthcare Provider Details
I. General information
NPI: 1699722470
Provider Name (Legal Business Name): SUMMIT MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 E WEISGARBER RD SUITE 200
KNOXVILLE TN
37909-2604
US
IV. Provider business mailing address
1225 E WEISGARBER RD SUITE 200
KNOXVILLE TN
37909-2604
US
V. Phone/Fax
- Phone: 865-584-4747
- Fax: 865-584-1363
- Phone: 865-584-4747
- Fax: 865-584-1363
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ED
CURTIS
Title or Position: CAO
Credential:
Phone: 865-584-4747