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General NPI Number Information
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NPI Number | 1205919651
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Entity Type | Organization
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Legal Business Name | L. MICHAEL SHERROD, PH.D, , P.C.
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Dates
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Enumeration Date | 10/21/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 9217 PARK WEST BLVD SUITE D1
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City | KNOXVILLE
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State | TN
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Zip | 37923-4404
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Country | US
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Telephone | 865-691-2425
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Fax | 865-531-8440
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Provider Business Mailing Address
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Address Line | 9217 PARK WEST BLVD SUITE D1
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City | KNOXVILLE
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State | TN
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Zip | 37923-4404
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Country | US
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Telephone | 865-691-2425
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Fax | 865-531-8440
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. L. MICHAEL SHERROD
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Credential | PH.D.
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Telephone | 865-691-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 532
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License Number State | TN
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