Provider Demographics
NPI:1053392043
Name:HOVIS ORTHOPAEDIC CLINIC PC
Entity type:Organization
Organization Name:HOVIS ORTHOPAEDIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:HOVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-524-0054
Mailing Address - Street 1:501 19TH ST
Mailing Address - Street 2:STE 702
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1854
Mailing Address - Country:US
Mailing Address - Phone:865-524-0054
Mailing Address - Fax:865-524-7964
Practice Address - Street 1:501 19TH ST
Practice Address - Street 2:STE 702
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1854
Practice Address - Country:US
Practice Address - Phone:865-524-0054
Practice Address - Fax:865-524-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710823Medicaid
TN3710823Medicaid
TN0931070001Medicare NSC