=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720007941
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REGIONAL TRAUMA SURGEONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 04/09/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1932 ALCOA HWY STE 270
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37920-1537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-544-9433
-----------------------------------------------------
Fax | 865-544-8688
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 440268
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37244-0268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-670-6199
-----------------------------------------------------
Fax | 865-670-6158
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING SUPERVISOR
-----------------------------------------------------
Name | MRS. ADRIANNA D. PLUMMER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 865-251-4658
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0127X
-----------------------------------------------------
Taxonomy Name | Trauma Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------