Healthcare Provider Details

I. General information

NPI: 1588741680
Provider Name (Legal Business Name): TERESA M SALAZAR-CATRON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2648 SEVIERVILLE RD
MARYVILLE TN
37804-3643
US

IV. Provider business mailing address

PO BOX 4156
MARYVILLE TN
37802-4156
US

V. Phone/Fax

Practice location:
  • Phone: 865-984-1660
  • Fax: 865-982-1617
Mailing address:
  • Phone: 865-273-1752
  • Fax: 865-273-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35512
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number35512
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number35512
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35512
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: