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NPI Code Detail

MEDICARE: SUMMIT MEDICAL GROUP,PLLC

MEDICARE: SUMMIT MEDICAL GROUP,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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285199109
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT MEDICAL GROUP,PLLC
Provider Business Mailing Address
First Line : 1275 DICK LONAS RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1326
Country : US
Telephone Number : 865-584-4747
Fax Number : 865-584-1363
Provider Business Practice Location Address
First Line : 280 FT SANDERS W BLVD STE 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3352
Country : US
Telephone Number : 865-539-0270
Fax Number : 865-539-6998
Authorized Official
Title or Position : CEO
Name : ED CURTIS
Credential : CMPE,CEO
Telephone Number : 865-584-4747
Provider Enumeration Date : 02/05/2019
Last Update Date : 06/21/2022

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