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NPI Code Detail

MEDICARE: DR. SAMUEL SPEARS FROGG II DPT

MEDICARE: DR. SAMUEL SPEARS FROGG II DPT
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
1225100000XPhysical TherapistPT0000007073TN

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 : 1679652804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL SPEARS FROGG II DPT
Provider Business Mailing Address
First Line : 613 DRAKEWOOD RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-3434
Country : US
Telephone Number : 865-414-0898
Fax Number :
Provider Business Practice Location Address
First Line : 8309 ASHEVILLE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-4102
Country : US
Telephone Number : 865-932-1334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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