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General NPI Number Information
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NPI Number | 1689632119
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Entity Type | Organization
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Legal Business Name | CHILDREN'S WEST SURGERY CENTER
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1020 CHILDRENS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-7712
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Country | US
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Telephone | 865-560-0303
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Fax | 865-670-9082
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Provider Business Mailing Address
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Address Line | 1020 CHILDRENS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-7712
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Country | US
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Telephone | 865-560-0303
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Fax | 865-670-9082
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBORAH TAYLOR WOMBLE
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Credential | RN, CNOR
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Telephone | 865-560-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0000000141
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License Number State | TN
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