Healthcare Provider Details

I. General information

NPI: 1750806550
Provider Name (Legal Business Name): KRISHNA K PATEL PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US

IV. Provider business mailing address

3650 RAVEN GROVE WAY APT 630
KNOXVILLE TN
37918-7095
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3453
  • Fax:
Mailing address:
  • Phone: 573-268-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41234
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: