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EAST TENNESSEE FOOT CLINIC PC NPI 1255376083


NPI Information

NPI: 1255376083
Provider Name: EAST TENNESSEE FOOT CLINIC PC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
603 SMITHVIEW DR
MARYVILLE, TN
ZIP 37803
Phone: (865) 981-4595
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EAST TENNESSEE FOOT CLINIC PC is a podiatrist in Maryville, TN. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. EAST TENNESSEE FOOT CLINIC PC NPI is 1255376083. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

603 SMITHVIEW DR
MARYVILLE, TN
ZIP 37803-100
Phone: (865) 981-4595
Fax: (865) 981-4544

The provider's authorized official is Laurel Burger Cook .
The authorized official title is President and has the following contact phone number (865) 981-4595.

The enumeration date for this NPI number is 6/17/2006 and was last updated on 10/14/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist641TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U71317MEDICARE UPINTENNESSEE
25763670001MEDICARE NSCTENNESSEE
33733969MEDICARE PINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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