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General NPI Number Information
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NPI Number | 1821524430
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Entity Type | Organization
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Legal Business Name | 5534 MEDICAL, INC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 6626 CENTRAL AVENUE PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37912-1400
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Country | US
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Telephone | 865-249-6214
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Fax | 865-249-6503
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Provider Business Mailing Address
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Address Line | 6626 CENTRAL AVENUE PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37912-1400
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Country | US
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Telephone | 865-249-6214
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Fax | 865-249-6503
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL CORUM
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Credential |
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Telephone | 865-919-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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