Provider Demographics
NPI:1811224348
Name:CAMPBELL CUNNINGHAM & TAYLOR, PC
Entity Type:Organization
Organization Name:CAMPBELL CUNNINGHAM & TAYLOR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS COORD
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING DEPT
Authorized Official - Phone:865-584-2127
Mailing Address - Street 1:12744 KINGSTON PIKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0940
Mailing Address - Country:US
Mailing Address - Phone:865-934-1700
Mailing Address - Fax:865-392-5533
Practice Address - Street 1:12744 KINGSTON PIKE
Practice Address - Street 2:SUITE 108
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-0940
Practice Address - Country:US
Practice Address - Phone:865-934-1700
Practice Address - Fax:865-392-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3371152Medicaid
TN645010002OtherDME
TN3371152OtherMEDICARE