=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578626073
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH J HULL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2006
-----------------------------------------------------
Last Update Date | 12/17/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 742 MIDDLE CREEK RD
-----------------------------------------------------
City | SEVIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37862-5019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-446-8835
-----------------------------------------------------
Fax | 865-446-8840
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 343
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37901-0343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-525-9414
-----------------------------------------------------
Fax | 865-525-9452
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 37246
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 37246
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------