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General NPI Number Information
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NPI Number | 1639405483
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Entity Type | Organization
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Legal Business Name | CAMPBELL CUNNINGHAM TAYLOR PC
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 628 SMITHVIEW DR
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City | MARYVILLE
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State | TN
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Zip | 37803-6100
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Country | US
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Telephone | 865-984-7012
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Fax | 865-981-4401
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Provider Business Mailing Address
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Address Line | 628 SMITHVIEW DR
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City | MARYVILLE
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State | TN
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Zip | 37803-6100
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Country | US
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Telephone | 865-984-7012
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Fax | 865-981-4401
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Authorized Official
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Title or Position | CREDENTIALS COORDINATOR
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Name | MRS. RHONDA M GARRISON
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Credential | BILLING DEPT
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Telephone | 865-584-2127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD021400
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD0034217
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD0008625
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD029986
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | OD001240
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | OD002250
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD016011
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License Number State | TN
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