Organization
TCMC WOUND CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER MILLWOOD (PRESIDENT)
(865) 228-4541
Entity
Organization
Contact information
Practice address
10820 PARKSIDE DR, KNOXVILLE, TN 37934-1956
(865) 218-2302
Mailing address
875 HIGHWAY 321 N, SUITE 600-227, LENOIR CITY, TN 37771-7397
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
MD018122
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124181532
MEDICARE NPI
TN
01
—
174400000X
TAXONOMY CODE
TN
05
—
3029164
—
TN
Enumeration date
01/30/2014
Last updated
01/30/2014
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