Provider Demographics
NPI:1164589628
Name:EAST TENNESSEE SURGICAL GROUP, P.C.
Entity Type:Organization
Organization Name:EAST TENNESSEE SURGICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SCHUCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-673-0288
Mailing Address - Street 1:2001 LAUREL AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1810
Mailing Address - Country:US
Mailing Address - Phone:865-673-0288
Mailing Address - Fax:865-522-8712
Practice Address - Street 1:2001 LAUREL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1810
Practice Address - Country:US
Practice Address - Phone:865-673-0288
Practice Address - Fax:865-522-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE57540Medicare UPIN
TN3052218Medicare ID - Type UnspecifiedGEORGE DOUGLAS SCHUHMANN
TN3648278Medicare ID - Type UnspecifiedMAUREEN CADMUS
TNQ38802Medicare UPIN