MARYVILLE ASC NPI 1073593109

NPI Information

NPI: 1073593109
Provider Name: MARYVILLE ASC

Doing Business As: TENNESSEE ENDOSCOPY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1706 E LAMAR ALEXANDER PKWY
MARYVILLE, TN
ZIP 37804
Phone: (865) 983-0073
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MARYVILLE ASC is an ambulatory surgical clinic center in Maryville, TN. MARYVILLE ASC NPI is 1073593109. The provider is registered as an organization entity type.
The provider Is Doing Business As Tennessee Endoscopy Center.

The provider's business location address is:

1706 E LAMAR ALEXANDER PKWY
MARYVILLE, TN
ZIP 37804-204
Phone: (865) 983-0073
Fax: (865) 681-5969

The provider's authorized official is Jeffrey Snodgrass .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 44D1105156 - other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/17/2006 and was last updated on 4/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	0000000001	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3287662	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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