Healthcare Provider Details

I. General information

NPI: 1992839427
Provider Name (Legal Business Name): STUART PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 ALCOA HWY SUITE 280
KNOXVILLE TN
37920-1527
US

IV. Provider business mailing address

1932 ALCOA HWY SUITE 280
KNOXVILLE TN
37920-1527
US

V. Phone/Fax

Practice location:
  • Phone: 865-329-4003
  • Fax: 865-329-4043
Mailing address:
  • Phone: 865-329-4003
  • Fax: 865-329-4043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number18992
License Number StateTN

VIII. Authorized Official

Name: MRS. TERESA NORRIS
Title or Position: CREDENTIALING COORDINATOR
Credential: CPC
Phone: 865-329-4003