1942232194 NPI number — TEAM PHYSICIANS, PC

Table of content: (NPI 1942232194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942232194 NPI number — TEAM PHYSICIANS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEAM PHYSICIANS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942232194
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 634008
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-4008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-985-7185
Provider Business Mailing Address Fax Number:
865-692-3390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1431 CENTERPOINT BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37932-1984
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-985-7185
Provider Business Practice Location Address Fax Number:
865-560-7379
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
865-985-7180

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DA3641 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: J611(DC) . This is a "CAREFIRST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019642170002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1526651 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1462682 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 150312 . This is a "THREE RIVERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50030915 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20031464 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50030915 . This is a "CAPITAL BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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