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General NPI Number Information
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NPI Number | 1689631137
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TENNESSEE
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1924 ALCOA HWY U-115
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 865-305-9351
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Fax | 865-305-9314
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Provider Business Mailing Address
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Address Line | 1924 ALCOA HWY U-67
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 865-305-9352
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Fax | 865-305-9314
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | KELLY MCDANIEL
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Credential | MPH
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Telephone | 865-305-9352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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