Provider Demographics
NPI:1578626073
Name:HULL, ELIZABETH J (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:J
Last Name:HULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-0343
Mailing Address - Country:US
Mailing Address - Phone:865-525-9414
Mailing Address - Fax:865-525-9452
Practice Address - Street 1:742 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5019
Practice Address - Country:US
Practice Address - Phone:865-446-8835
Practice Address - Fax:865-446-8840
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37246174400000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3885796Medicaid
TN3885796Medicaid
TN3885796Medicare ID - Type UnspecifiedMEDICARE