Healthcare Provider Details

I. General information

NPI: 1285255729
Provider Name (Legal Business Name): TAZEWELL ORTHOPAEDIC & ARTHRITIS CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 MAIN ST
TAZEWELL TN
37879-3426
US

IV. Provider business mailing address

1830 MAIN ST
TAZEWELL TN
37879-3426
US

V. Phone/Fax

Practice location:
  • Phone: 423-491-7444
  • Fax: 423-830-0665
Mailing address:
  • Phone: 423-491-7444
  • Fax: 423-830-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SADRIL MOHAMMAD
Title or Position: PHYSICIAN ASSISTANT
Credential:
Phone: 423-491-7444