Southeast Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTHEAST ORAL SURGERY PC

Practice address

11548 Chapman Hwy
Seymour, TN 37865

Phone

(865) 577-7800

NPI assigned

Apr 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle L Tracy

Title

Office Manager

Phone

(865) 977-7110

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1154596286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11548 CHAPMAN HWY",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "37865",
            "telephone_number": "865-577-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11548 CHAPMAN HWY",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "37865",
            "telephone_number": "865-577-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "865-977-7110"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitaker Michael Smith, MD
• Smokey Mountain Adult Care
• Smoky Mountain in-Home Care, LLC
• Smoky Mountain Mental Health, LLC
• Solace Therapeutics, Inc
• Clay Eugene Stalcup, MD
• Staci Kerr Stalcup, MD
• Steven F. Hall MD PC
• Megan Joyce Steverson, M.S., CCC-SLP
• Jeremy Ray Strader, NP

• Oral and Maxillofacial Surgery (Dentist) in Seymour, TN
• Providers in Seymour, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.