Healthcare Provider Details

I. General information

NPI: 1821142407
Provider Name (Legal Business Name): CHILD AND TEEN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 W EMORY RD
POWELL TN
37849-3704
US

IV. Provider business mailing address

2157 W EMORY RD
POWELL TN
37849-3704
US

V. Phone/Fax

Practice location:
  • Phone: 865-938-8336
  • Fax:
Mailing address:
  • Phone: 865-938-8336
  • Fax: 865-947-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL TIMOTHY MORRIS
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 865-938-8336