Provider Demographics
NPI:1457390676
Name:SALM, BARBARA (PA)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:SALM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4640
Mailing Address - Country:US
Mailing Address - Phone:865-531-9238
Mailing Address - Fax:865-531-9239
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:SUIT 119
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-305-8779
Practice Address - Fax:865-305-9869
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNPA264363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN204124194OtherTAX ID NUMBER
TN204124194OtherTAX ID NUMBER