| NPI | 1679917579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HAWK Owner 865-635-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |