Provider Demographics
NPI:1093877557
Name:TENNESSEE SURGICAL SPECIALISTS, PC
Entity Type:Organization
Organization Name:TENNESSEE SURGICAL SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-218-7470
Mailing Address - Street 1:PO BOX 22010
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-0010
Mailing Address - Country:US
Mailing Address - Phone:865-218-7470
Mailing Address - Fax:865-218-7471
Practice Address - Street 1:9217 PARK WEST BLVD
Practice Address - Street 2:SUITE C-2
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4404
Practice Address - Country:US
Practice Address - Phone:865-218-7470
Practice Address - Fax:865-218-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCN3546Medicare ID - Type UnspecifiedRR MEDICARE
TN3712188Medicare ID - Type UnspecifiedTN MEDICARE