Provider Demographics
NPI:1427610211
Name:US DIABETES CARE AND SURGICAL SPECIALTY OF MORRISTOWN TN
Entity type:Organization
Organization Name:US DIABETES CARE AND SURGICAL SPECIALTY OF MORRISTOWN TN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:HARRELL
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-616-0625
Mailing Address - Street 1:2231 SANDSTONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-0000
Mailing Address - Country:US
Mailing Address - Phone:423-616-0625
Mailing Address - Fax:423-616-0150
Practice Address - Street 1:2231 SANDSTONE DRIVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-0000
Practice Address - Country:US
Practice Address - Phone:423-616-0625
Practice Address - Fax:423-616-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty