Healthcare Provider Details

I. General information

NPI: 1699914507
Provider Name (Legal Business Name): STEVEN CHARLES COGSWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY DEPARTMENT OF PATHOLOGY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

1924 ALCOA HWY DEPARTMENT OF PATHOLOGY
KNOXVILLE TN
37920-1511
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9080
  • Fax: 865-305-6866
Mailing address:
  • Phone: 865-305-9080
  • Fax: 865-305-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number44497
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: