Provider Demographics
NPI:1679652804
Name:FROGG, SAMUEL SPEARS II (DPT)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:SPEARS
Last Name:FROGG
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 DRAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-3434
Mailing Address - Country:US
Mailing Address - Phone:865-414-0898
Mailing Address - Fax:
Practice Address - Street 1:8309 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-4102
Practice Address - Country:US
Practice Address - Phone:865-932-1334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446557Medicaid
TN0446557Medicaid