Organization
FORT SANDERS WEST OP SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY HINOJOSA SIMPSON (CREDENTIALING MANAGER)
(720) 630-0424
Entity
Organization
Contact information
Practice address
210 FORT SANDERS WEST BLVD, KNOXVILLE, TN 37922-3355
(865) 531-5200
(865) 531-5370
Mailing address
220 FORT SANDERS WEST BLVD, STE 200, KNOXVILLE, TN 37922-3398
(865) 531-5200
(865) 531-5370
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000025
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100020229
PHP TNCARE
TN
01
—
1000905
BLUE CROSS
TN
01
—
165264500
DEPARTMENT OF LABOR
TN
05
—
3287277
—
TN
01
—
702002007
CARITEN
TN
Enumeration date
08/01/2006
Last updated
05/14/2024
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