Prodigal Family Healthcare
Physician Assistant in Knoxville, TN. Organization (NPI-2).
NPI number1982021069
StatusActive
Last updated in NPPESMar 26, 2014
Details
- NPI
- 1982021069
- Entity type
- Organization (NPI-2)
- Legal business name
- Prodigal Family Healthcare
- Organization subpart
- No
- Enumeration date
- Mar 26, 2014
- Last updated
- Mar 26, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 1506 | TN | Yes |
Practice location
2911 Essary DrKnoxville, TN 37918-2468
Phone 865-288-3754 · Fax 865-394-6719
Mailing address
2911 Essary DrKnoxville, TN 37918-2468
Phone 865-288-3754 · Fax 865-394-6719
Authorized official
Sylvia Hofstetter
President
8652883754
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