| Organization Name: | EAST TENN NEUROLOGY CL PC |
| NPI Number: | 1932308293 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAM AL-KABBANI (PRESIDENT) |
| Mailing Address: | 9430 Parkwest Blvd Suite 350 Knoxville |
| State: | TN US |
| Postal Code: | 379234203 |
| Phone Number: | 8655319430 |
| Fax Number: | 8655319580 |
| NPI Enumeration Date: | 07/16/2007 |
| NPI Last Update Date: | 07/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | MD17875 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |