Healthcare Provider Details

I. General information

NPI: 1730105610
Provider Name (Legal Business Name): TERRY LEE ADAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9217 PARK WEST BLVD SUITE C-2
KNOXVILLE TN
37923-4404
US

IV. Provider business mailing address

PO BOX 22010
KNOXVILLE TN
37933-0010
US

V. Phone/Fax

Practice location:
  • Phone: 865-218-7470
  • Fax: 865-218-7471
Mailing address:
  • Phone: 865-218-7470
  • Fax: 865-218-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD013554
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD013554
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: