Healthcare Provider Details

I. General information

NPI: 1922583780
Provider Name (Legal Business Name): UNIVERSITY HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 ALCOA HWY STE 205
KNOXVILLE TN
37920-1504
US

IV. Provider business mailing address

PO BOX 415000-MSC8152
NASHVILLE TN
37241-8152
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-4305
  • Fax: 865-305-4067
Mailing address:
  • Phone: 865-670-6199
  • Fax: 865-670-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL

VIII. Authorized Official

Name: BETH A. MAYNARD
Title or Position: VICE PRESIDENT
Credential:
Phone: 865-305-6427