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General NPI Number Information
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NPI Number | 1326054172
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Entity Type | Organization
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Legal Business Name | FORT SANDERS WEST OP SURGERY CENTER
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 210 FORT SANDERS WEST BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-3355
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Country | US
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Telephone | 865-531-5200
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Fax | 865-531-5370
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Provider Business Mailing Address
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Address Line | 220 FORT SANDERS WEST BLVD STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37922-3398
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Country | US
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Telephone | 865-531-5200
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Fax | 865-531-5370
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | EMILY HINOJOSA SIMPSON
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Credential |
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Telephone | 720-630-0424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0000000025
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License Number State | TN
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