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General NPI Number Information
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NPI Number | 1710115878
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Entity Type | Organization
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Legal Business Name | PARKWEST PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 9239 PARK WEST BLVD SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37923-4403
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Country | US
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Telephone | 865-256-0200
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Fax | 865-246-6711
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Provider Business Mailing Address
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Address Line | 9239 PARK WEST BLVD SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37923-4403
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Country | US
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Telephone | 865-246-0200
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Fax | 865-246-6711
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Authorized Official
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Title or Position | OWNER, SURGEON
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Name | DR. STEVEN JAMES SMITH
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Credential | M.D.
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Telephone | 865-246-0200
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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 | 0000000209
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License Number State | TN
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