Provider Demographics
NPI:1689612640
Name:HYPERBARIC WOUND SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:HYPERBARIC WOUND SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-482-4028
Mailing Address - Street 1:969 OAK RIDGE TPKE
Mailing Address - Street 2:PMB 222
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-8832
Mailing Address - Country:US
Mailing Address - Phone:865-482-4028
Mailing Address - Fax:865-481-3257
Practice Address - Street 1:160A W TENNESSEE AVE
Practice Address - Street 2:THE WOUND TREATMENT CENTER
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6501
Practice Address - Country:US
Practice Address - Phone:865-835-5374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3734106Medicaid
TN3734106Medicaid