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General NPI Number Information
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NPI Number | 1194768085
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Entity Type | Individual
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Provider Name | GARY P. HURT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 1924 ALCOA HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 269-762-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 HAWK HILL WAY
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City | MARYVILLE
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State | TN
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Zip | 37801-3554
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 54585
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License Number State | TN
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