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General NPI Number Information
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NPI Number | 1063421550
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Entity Type | Organization
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Legal Business Name | PATHOLOGY MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 129 E DIVISION RD
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City | OAK RIDGE
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State | TN
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Zip | 37830-6907
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Country | US
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Telephone | 865-548-2963
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Fax | 865-482-9655
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Provider Business Mailing Address
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Address Line | 129 E DIVISION RD
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City | OAK RIDGE
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State | TN
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Zip | 37830-6907
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Country | US
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Telephone | 865-548-2963
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Fax | 865-482-9655
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELOISE GRIFFITH
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Credential |
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Telephone | 865-482-9633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | TN
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