Healthcare Provider Details

I. General information

NPI: 1619141306
Provider Name (Legal Business Name): INNOVATIVE PATHOLOGY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 19TH ST SUITE 301
KNOXVILLE TN
37916-1854
US

IV. Provider business mailing address

PO BOX 60820
NORTH CHARLESTON SC
29419-0820
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-7591
  • Fax: 865-546-2618
Mailing address:
  • Phone: 843-554-9300
  • Fax: 843-566-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANK JOSEPH BEUERLEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 865-522-7591