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General NPI Number Information
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NPI Number | 1760940613
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Entity Type | Organization
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Legal Business Name | MARBLE CITY MEDICAL PLLC
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 6010 BURNETT CREEK RD
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 864-902-3983
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Fax | 865-859-0326
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Provider Business Mailing Address
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Address Line | 6010 BURNETT CREEK RD
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 386-490-2398
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Fax | 865-859-0326
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Authorized Official
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Title or Position | OWNER
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Name | COURTNEY BLACKWELL MCLEOD
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Credential | NP
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Telephone | 386-490-2398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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