MEDICARE: DR. EDWARD B TIENG 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	208800000X	Urology Physician	MD0000039470	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CI2260	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1669416442	OTHER	TN	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3106057	OTHER	TN	BLUE CROSS
5	4104939	OTHER	TN	BLUE CROSS
6	020252399	OTHER	TN	EEOICP

General Provider Information

NPI Number	:	1184624140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD B TIENG M.D.

Provider Business Mailing Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE 502
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-331-9000
Fax Number	:	865-331-7000

Provider Business Practice Location Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE 502
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-331-9000
Fax Number	:	865-331-7000

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	06/23/2020

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Directions to “ DR. EDWARD B TIENG M.D.” Practice Location

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