Healthcare Provider Details

I. General information

NPI: 1437432754
Provider Name (Legal Business Name): SKYVIEW MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11653 CHAPMAN HWY
SEYMOUR TN
37865-5099
US

IV. Provider business mailing address

11653 CHAPMAN HWY
SEYMOUR TN
37865-5099
US

V. Phone/Fax

Practice location:
  • Phone: 865-773-0327
  • Fax: 865-773-0339
Mailing address:
  • Phone: 865-773-0327
  • Fax: 865-773-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. DARREL G REED
Title or Position: OWNER
Credential:
Phone: 865-773-0327