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General NPI Number Information
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NPI Number | 1598070807
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Entity Type | Organization
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Legal Business Name | TENNESSEE VEIN CENTER, PLLC
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 203 CORPORATE PLACE
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City | ALCOA
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State | TN
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Zip | 37701
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Country | US
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Telephone | 865-365-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 12925 LAUREL BROOKE LN
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City | KNOXVILLE
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State | TN
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Zip | 37934-4453
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Country | US
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Telephone | 865-671-0904
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH EARL CAMPBELL
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Credential | M.D.
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Telephone | 865-368-8753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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