# COMMONWEALTH MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942698345
- **Authorized official:** THEO S STEPHENS (INFRASTRUCTURE AND DESIGN CONCEPTS)
- **Authorized official phone:** (865) 936-5635

## Contact information

- **Practice address:** 2427 PINEY GROVE CHURCH RD, KNOXVILLE, TN 37921-3765
- **Practice address phone:** (865) 936-5635
- **Practice address fax:** (865) 622-3885
- **Mailing address:** 5210 S MIDDLEBROOK PIKE, KNOXVILLE, TN 37921-5972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 01/07/2015