Healthcare Provider Details

I. General information

NPI: 1346228004
Provider Name (Legal Business Name): HOSPITALIST GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 BLOUNT AVE SUITE 507
KNOXVILLE TN
37920
US

IV. Provider business mailing address

PO BOX 779
JOHNSON CITY TN
37605-0779
US

V. Phone/Fax

Practice location:
  • Phone: 865-525-0598
  • Fax: 865-525-0598
Mailing address:
  • Phone: 423-928-1145
  • Fax: 423-928-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN A RUSSELL
Title or Position: DIRECTOR
Credential:
Phone: 865-525-0598