Healthcare Provider Details

I. General information

NPI: 1063300234
Provider Name (Legal Business Name): PHOENIX SPINE AND HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E HILL AVE STE 205
KNOXVILLE TN
37915-2563
US

IV. Provider business mailing address

900 E HILL AVE STE 205
KNOXVILLE TN
37915-2563
US

V. Phone/Fax

Practice location:
  • Phone: 865-415-2620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID NEWPORT
Title or Position: AUTHORIZED OFFICIAL
Credential: DO
Phone: 652-168-7878