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General NPI Number Information
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NPI Number | 1265674550
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Entity Type | Organization
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Legal Business Name | SPECTRUM HEALTH ASSOCIATES LLC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 12/08/2012
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Provider Practice Location Address
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Address Line | 2620 MINERAL SPRINGS AVE SUITE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-1569
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Country | US
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Telephone | 865-219-6968
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Fax | 865-219-8636
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Provider Business Mailing Address
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Address Line | 2620 MINERAL SPRINGS AVE SUITE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-1570
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Country | US
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Telephone | 865-219-6968
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Fax | 865-219-8636
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Authorized Official
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Title or Position | CEO
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Name | ERNEST E PICKETT
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Credential |
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Telephone | 865-384-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000020655
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000026566
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000027527
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN000006240
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000030531
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000039023
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD0000019665
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN0000077192
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License Number State | TN
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA0000000518
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License Number State | TN
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15673
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License Number State | TN
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Taxonomy #11
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000027033
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License Number State | TN
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