Provider Demographics
NPI:1770591323
Name:STUHL, JOHN H
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:STUHL
Suffix:
Gender:M
Credentials:
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 1694
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-1694
Mailing Address - Country:US
Mailing Address - Phone:864-947-9113
Mailing Address - Fax:865-947-9146
Practice Address - Street 1:109 STEKOIA LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1608
Practice Address - Country:US
Practice Address - Phone:865-947-9113
Practice Address - Fax:865-675-4853
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP000002053103TC1900X
TNP0000002053103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3688805Medicaid
TN3044251OtherBC/BS OF TN
TN3688805Medicare UPIN