Healthcare Provider Details

I. General information

NPI: 1407174493
Provider Name (Legal Business Name): CURTIS SHANNON GAYLORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 OLD WEISGARBER RD
KNOXVILLE TN
37909-1293
US

IV. Provider business mailing address

1422 OLD WEISGARBER RD
KNOXVILLE TN
37909-1293
US

V. Phone/Fax

Practice location:
  • Phone: 865-558-4400
  • Fax:
Mailing address:
  • Phone: 865-558-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number54510
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number54510
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: