Provider Demographics
NPI:1548909294
Name:LINCOLN MEMORIAL UNIVERSITY
Entity type:Organization
Organization Name:LINCOLN MEMORIAL UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-869-6229
Mailing Address - Street 1:6965 CUMBERLAND GAP PARKWAY
Mailing Address - Street 2:FINANCE OFFICE
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-8245
Mailing Address - Country:US
Mailing Address - Phone:423-869-6229
Mailing Address - Fax:423-869-6229
Practice Address - Street 1:1705 ST. MARY STREET
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:865-370-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN MEMORIAL UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No1223X0008XDental ProvidersDentistOral and Maxillofacial RadiologyGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty