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General NPI Number Information
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NPI Number | 1114027224
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Entity Type | Organization
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Legal Business Name | DAYSPRING FAMILY CARE PLLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 7341 CHAPMAN HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-6681
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Country | US
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Telephone | 865-577-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 7341 CHAPMAN HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-6681
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Country | US
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Telephone | 865-548-4477
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DENA L DEWEESE
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Credential |
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Telephone | 865-548-4477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA0000000971
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License Number State | TN
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