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General NPI Number Information
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NPI Number | 1013938026
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALISTS PLLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 2301 N OCOEE ST SUITE B
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City | CLEVELAND
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State | TN
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Zip | 37311-3863
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Country | US
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Telephone | 423-479-9647
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Fax | 423-479-2216
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Provider Business Mailing Address
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Address Line | 2301 N OCOEE STREET SUITE B
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-479-9647
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Fax | 423-479-2216
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES L KNABB
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Credential | MD
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Telephone | 423-479-9647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | TN
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