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NPI Code Detail

MEDICARE: ADVANCED SURGICAL WOUND CENTER PLLC

MEDICARE: ADVANCED SURGICAL WOUND CENTER PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2207R00000XInternal Medicine Physician
3207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1225800410
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED SURGICAL WOUND CENTER PLLC
Provider Business Mailing Address
First Line : 3511 RIVEREDGE CIR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-2890
Country : US
Telephone Number : 865-470-6121
Fax Number : 423-500-3029
Provider Business Practice Location Address
First Line : 6216 HIGHLAND PLACE WAY STE 102
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-4068
Country : US
Telephone Number : 865-470-6121
Fax Number : 423-500-3029
Authorized Official
Title or Position : OWNER
Name : LOWELL L MCCAULEY JR.
Credential : M.D.
Telephone Number : 865-549-5151
Provider Enumeration Date : 10/23/2023
Last Update Date : 03/13/2026

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