Organization
EAST TENN NEUROLOGY CL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM AL-KABBANI MD (PRESIDENT)
(865) 531-9430
Entity
Organization
Contact information
Practice address
9430 PARKWEST BLVD, SUITE 350, KNOXVILLE, TN 37923-4203
(865) 531-9430
(865) 531-9580
Mailing address
9430 PARKWEST BLVD, SUITE 350, KNOXVILLE, TN 37923
(865) 531-9430
(865) 531-9580
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
MD17875
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3386763
—
TN
Enumeration date
07/16/2007
Last updated
07/19/2007
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