Healthcare Provider Details

I. General information

NPI: 1356678882
Provider Name (Legal Business Name): CAMPBELL CUNNINGHAM TAYLOR PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

962 DOLLY PARTON PKWY
SEVIERVILLE TN
37862-3707
US

IV. Provider business mailing address

962 DOLLY PARTON PKWY
SEVIERVILLE TN
37862-3707
US

V. Phone/Fax

Practice location:
  • Phone: 865-428-8000
  • Fax: 865-428-2091
Mailing address:
  • Phone: 865-428-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. LESLIE B. CUNNINGHAM
Title or Position: MD
Credential: MD
Phone: 865-584-2127