Serrell, Paul Burt

Serrell, Paul Burt is an individual health care provider with primary practice located at 2018 Western Ave , Knoxville TN 37921-5718. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Serrell, Paul Burt can be contacted via phone (865) 544-0406.

Contact Information

Primary practice address
2018 Western Ave Knoxville TN 37921-5718
Phone: (865) 544-0406
Fax: (865) 544-0480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD10143 Tennessee

Profile Details

NPI number 1407849649
LBN Legal business name Serrell, Paul Burt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Sep 29th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407849649 NPPES
Tennessee Other 3149814 BLUE CROSS/BLUE SHIELD
Tennessee Other 390007315 BLUE CROSS/BLUE SHIELD
Tennessee MEDICAID 3723987 BLUE CROSS/BLUE SHIELD

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