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General NPI Number Information
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NPI Number | 1386678936
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Entity Type | Individual
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Provider Name | DAVID WAYNE SANFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 502 WINFIELD DUNN PKWY
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City | SEVIERVILLE
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State | TN
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Zip | 37876-5509
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Country | US
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Telephone | 865-453-4434
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Fax | 866-610-2903
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Provider Business Mailing Address
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Address Line | PO BOX 15004
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City | KNOXVILLE
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State | TN
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Zip | 37901-5004
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Country | US
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Telephone | 865-541-8895
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Fax | 865-633-4808
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 60866
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License Number State | TN
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