Basic Information
| Provider Information | |||||||||
| NPI: | 1922492248 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUMMINS | ||||||||
| FirstName: | MARY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 415000-MSC8135 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372418135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656706199 | ||||||||
| FaxNumber: | 8656706198 | ||||||||
| Practice Location | |||||||||
| Address1: | 1924 ALCOA HWY # U56 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653059081 | ||||||||
| FaxNumber: | 8653058769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2015 | ||||||||
| LastUpdateDate: | 01/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0102205116 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 3788 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 0102205116 | VA | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 3788 | TN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.