Provider Demographics
NPI:1609086214
Name:COURTS, MARC VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:VINCENT
Last Name:COURTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-1323
Mailing Address - Country:US
Mailing Address - Phone:865-458-5666
Mailing Address - Fax:865-458-9906
Practice Address - Street 1:616 WARD AVE
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-1323
Practice Address - Country:US
Practice Address - Phone:865-458-5666
Practice Address - Fax:865-458-9906
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43430208000000X, 207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1503975Medicaid