Provider Demographics
NPI:1225214307
Name:ELMER G. PINZON
Entity Type:Organization
Organization Name:ELMER G. PINZON
Other - Org Name:UNIVERSITY SPINE & SPORTS SPECIALIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:G
Authorized Official - Last Name:PINZON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-690-3737
Mailing Address - Street 1:PO BOX 63141
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3141
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:110 CENTER PARK DR
Practice Address - Street 2:STE 102 & 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2114
Practice Address - Country:US
Practice Address - Phone:865-690-3737
Practice Address - Fax:865-690-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 358712081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38717082Medicaid
TN38717082Medicare PIN