| NPI | 1962845107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L HAWK Office Manager 865-635-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-04-08 |