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General NPI Number Information
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NPI Number | 1891981007
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Entity Type | Organization
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Legal Business Name | BLM NEUROSURGERY
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 9000 EXECUTIVE PARK DR SUITE A-207
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City | KNOXVILLE
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State | TN
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Zip | 37923-4685
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Country | US
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Telephone | 865-523-4300
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Fax | 865-523-4100
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Provider Business Mailing Address
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Address Line | 9000 EXECUTIVE PARK DR SUITE A-207
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City | KNOXVILLE
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State | TN
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Zip | 37923-4685
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Country | US
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Telephone | 865-523-4300
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Fax | 865-523-4100
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT LOUIS MERIC III
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Credential | M.D.
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Telephone | 865-523-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 018355
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License Number State | TN
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