MANCEL WAKHAM DO PC NPI 1497952600

NPI Information

  • NPI: 1497952600
  • Provider Name: MANCEL WAKHAM, DO PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 2497 S ROANE ST
    SUITE 110
    HARRIMAN, TN
    ZIP 37748
  • Phone: (865) 590-0889

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NPI Details

MANCEL WAKHAM, DO PC is a family medicine in Harriman, TN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MANCEL WAKHAM, DO PC NPI is 1497952600. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2497 S ROANE ST
SUITE 110
HARRIMAN, TN
ZIP 37748
Phone: (865) 590-0889
Fax: (865) 590-0884

The provider's authorized official is Lisa Packett .
The authorized official title is Manager and has the following contact phone number (865) 321-0048.

The enumeration date for this NPI number is 6/29/2007 and was last updated on 7/24/2020.

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
1207Q00000XFamily MedicineD00000000982TENNESSEEYes

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
13725874MEDICAIDTENNESSEE

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: 11/21/2025

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