Provider Demographics
NPI:1942243167
Name:UNIVERSITY GENERAL SURGEONS, P. C.
Entity Type:Organization
Organization Name:UNIVERSITY GENERAL SURGEONS, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-251-4658
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:SUITE 270/C
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-251-4658
Mailing Address - Fax:865-251-4659
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:SUITE 270/C
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-342-5045
Practice Address - Fax:865-251-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3706303Medicaid
TNCA2361Medicare PIN
TN3706303Medicaid