Healthcare Provider Details
I. General information
NPI: 1184190712
Provider Name (Legal Business Name): PAUL MICHAEL MCCURRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/22/2018
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2014 STILL WATER LN
KNOXVILLE TN
37922-5657
US
IV. Provider business mailing address
2014 STILL WATER LN
KNOXVILLE TN
37922-5657
US
V. Phone/Fax
- Phone: 615-300-5775
- Fax:
- Phone: 615-300-5775
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | 29915 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0011X |
| Taxonomy | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| License Number | 29915 |
| License Number State | TN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LA0401X |
| Taxonomy | Addiction Medicine (Anesthesiology) Physician |
| License Number | 29915 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: