MEDICARE: DR. JOHN CRAWFORD ROCHESTER M.D.

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	208000000X	Pediatrics Physician	MD0000005120	TN

General Provider Information

NPI Number	:	1144211210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CRAWFORD ROCHESTER M.D.

Provider Business Mailing Address
First Line	:	224 S PETERS RD
Second Line	:	SUITE 105
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-5207
Country	:	US
Telephone Number	:	865-693-5016
Fax Number	:	865-539-0956

Provider Business Practice Location Address
First Line	:	224 S PETERS RD
Second Line	:	SUITE 105
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-5207
Country	:	US
Telephone Number	:	865-693-5016
Fax Number	:	865-539-0956

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	07/08/2007

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