Provider Demographics
NPI:1245772391
Name:UNIVERSITY HEALTH SYSTEM DBA UNIVERSITY SURGICAL ONCOLOGY
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH SYSTEM DBA UNIVERSITY SURGICAL ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-305-9218
Mailing Address - Street 1:1926 ALCOA HWY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1545
Mailing Address - Country:US
Mailing Address - Phone:865-305-9218
Mailing Address - Fax:
Practice Address - Street 1:1926 ALCOA HWY
Practice Address - Street 2:SUITE 330
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-305-9218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3137363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty