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General NPI Number Information
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NPI Number | 1023092426
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Entity Type | Organization
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Legal Business Name | MPS-CARDIOLOGY LLC
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 1225 E WEISGARBER RD SUITE 190
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City | KNOXVILLE
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State | TN
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Zip | 37909-2604
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Country | US
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Telephone | 865-602-6700
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Fax | 865-602-6801
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Provider Business Mailing Address
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Address Line | 1225 E WEISGARBER RD SUITE 190
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City | KNOXVILLE
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State | TN
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Zip | 37909-2604
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Country | US
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Telephone | 865-602-6700
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Fax | 865-602-6801
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | DR. WILLIAM MINTEER
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Credential | M.D.
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Telephone | 865-525-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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