Healthcare Provider Details

I. General information

NPI: 1578626073
Provider Name (Legal Business Name): ELIZABETH J HULL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 MIDDLE CREEK RD
SEVIERVILLE TN
37862-5019
US

IV. Provider business mailing address

PO BOX 343
KNOXVILLE TN
37901-0343
US

V. Phone/Fax

Practice location:
  • Phone: 865-446-8835
  • Fax: 865-446-8840
Mailing address:
  • Phone: 865-525-9414
  • Fax: 865-525-9452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number37246
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37246
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: