MEDICARE: CAMPBELL CUNNINGHAM & TAYLOR, PC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	MD16011	TN
2	332B00000X	Durable Medical Equipment & Medical Supplies	MD21400	TN
3	332B00000X	Durable Medical Equipment & Medical Supplies	MD29986	TN
4	332B00000X	Durable Medical Equipment & Medical Supplies	MD34217	TN
5	332B00000X	Durable Medical Equipment & Medical Supplies	MD49890	TN
6	332B00000X	Durable Medical Equipment & Medical Supplies	OD1240	TN
7	332B00000X	Durable Medical Equipment & Medical Supplies	OD2250	TN
8	332B00000X	Durable Medical Equipment & Medical Supplies	OD00520	TN
9	332B00000X	Durable Medical Equipment & Medical Supplies	OD03062	TN
10	332B00000X	Durable Medical Equipment & Medical Supplies	OD2937	TN

General Provider Information

NPI Number	:	1427507375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMPBELL CUNNINGHAM & TAYLOR, PC

Provider Business Mailing Address
First Line	:	4829 N BROADWAY ST
Second Line	:	STE 103
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2066
Country	:	US
Telephone Number	:	865-851-8558
Fax Number	:	865-500-8153

Provider Business Practice Location Address
First Line	:	4829 N BROADWAY ST
Second Line	:	STE 103
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2066
Country	:	US
Telephone Number	:	865-851-8558
Fax Number	:	865-500-8153

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	RHONDA M GARRISON
Credential	:
Telephone Number	:	865-584-2127

Provider Enumeration Date	:	10/03/2016
Last Update Date	:	03/16/2017

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