Individual
SAMUEL LOUIS MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4820 OLD KINGSTON PIKE, KNOXVILLE, TN 37919-6424
(865) 558-9862
(865) 584-3478
Mailing address
4820 OLD KINGSTON PIKE, KNOXVILLE, TN 37919-6424
(865) 558-9862
(865) 584-3478
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34093
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3706632
MEDICARE GROUP #
TN
05
—
3852806
—
TN
05
—
3852807
—
TN
Enumeration date
06/30/2005
Last updated
03/30/2026
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