MEDICARE: GARY D. OSHAUGHNESSY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DO 682	TN

General Provider Information

NPI Number	:	1083612493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY D. OSHAUGHNESSY D.O.

Provider Business Mailing Address
First Line	:	1346 PAPERMILL POINTE WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-1903
Country	:	US
Telephone Number	:	865-673-5000
Fax Number	:	865-588-5711

Provider Business Practice Location Address
First Line	:	1346 PAPERMILL POINTE WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-1903
Country	:	US
Telephone Number	:	865-673-5000
Fax Number	:	865-588-5711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	10/12/2011

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