Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 54510 | TN |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 54510 | TN |
NPI | 1407174493 |
---|---|
Provider Name | Curtis Shannon Gaylord |
First Address | Knoxville, TN 37922-3355 |
Second Address | Knoxville, TN 37922-3355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 07/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q024241 | (05) | TN |