Healthcare Provider Details
I. General information
NPI: 1053392043
Provider Name (Legal Business Name): HOVIS ORTHOPAEDIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2005
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 19TH ST STE 702
KNOXVILLE TN
37916-1854
US
IV. Provider business mailing address
501 19TH ST STE 702
KNOXVILLE TN
37916-1854
US
V. Phone/Fax
- Phone: 865-524-0054
- Fax: 865-524-7964
- Phone: 865-524-0054
- Fax: 865-524-7964
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
MARVIN
HOVIS
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 865-524-0054