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General NPI Number Information
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NPI Number | 1215392030
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Entity Type | Organization
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Legal Business Name | GI FOR KIDS, PLLC
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 1975 TOWN CENTER BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-6638
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Country | US
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Telephone | 865-546-3998
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Fax | 865-546-1123
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Provider Business Mailing Address
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Address Line | DEPT 888260
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City | KNOXVILLE
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State | TN
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Zip | 37995-8260
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6198
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Authorized Official
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Title or Position | OWNER
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Name | YOUHANNA S. AL-TAWIL
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Credential | MD
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Telephone | 865-546-3998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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