Organization
SOUTHERN MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY A KANIPE (CREDENTIALING)
(865) 632-5885
Entity
Organization
Contact information
Practice address
6600 NIGHTINGALE LN, KNOXVILLE, TN 37909-2754
(865) 632-5885
(865) 632-5893
Mailing address
6600 NIGHTINGALE LN, KNOXVILLE, TN 37909-2754
(865) 632-5885
(865) 632-5893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611721701
FEDERAL BALCK LUNG
TN
Enumeration date
01/17/2007
Last updated
11/15/2011
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