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NPI Code Detail

MEDICARE: KNOXVILLE DIETITIAN SERVICES

MEDICARE: KNOXVILLE DIETITIAN SERVICES
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1538758560
Entity Type Code : Organization
Provider Name (Legal Business Name) : KNOXVILLE DIETITIAN SERVICES
Provider Business Mailing Address
First Line : 407 N FOREST PARK BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5136
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 407 N FOREST PARK BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5136
Country : US
Telephone Number : 865-226-9615
Fax Number :
Authorized Official
Title or Position : OWNER
Name : PAYTON TURNER
Credential :
Telephone Number : 865-599-7234
Provider Enumeration Date : 01/14/2021
Last Update Date : 01/14/2021

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Directions to “KNOXVILLE DIETITIAN SERVICES ” Practice Location

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