Individual
MICHAEL SCOTT GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
603 SMITHVIEW DR, MARYVILLE, TN 37803-6100
(865) 983-0082
(865) 977-1171
Mailing address
1275 DICK LONAS RD, KNOXVILLE, TN 37909-1382
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1652
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3331497
—
TN
01
—
P00251643
RR MEDICARE PIN
TN
Enumeration date
06/27/2006
Last updated
01/03/2020
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