Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 51018 | TN |
Y | 2080P0202X | Pediatric Cardiologist | 51018 | TN |
NPI | 1174601090 |
---|---|
Provider Name | David Matthew Hurst |
First Address | Knoxville, TN 37901-5004 |
Second Address | Knoxville, TN 37916-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q007650 | (05) | TN |