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General NPI Number Information
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NPI Number | 1265639405
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Entity Type | Organization
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Legal Business Name | SAMUEL W. MCGAHA
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1235 DOLLY PARTON PARKWAY SUITE #2
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City | SEVIERVILLE
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State | TN
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Zip | 37862
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Country | US
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Telephone | 865-428-6088
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Fax | 865-774-9745
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Provider Business Mailing Address
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Address Line | 1235 DOLLY PARTON PARKWAY SUITE #2
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City | SEVIERVILLE
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State | TN
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Zip | 37862
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Country | US
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Telephone | 865-428-6088
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Fax | 865-774-9745
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SAMUEL W. MCGAHA
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Credential | M.D.
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Telephone | 865-428-6088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD010012
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License Number State | TN
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