Healthcare Provider Details

I. General information

NPI: 1326095035
Provider Name (Legal Business Name): RANDAL L. DABBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W CLINCH AVE
KNOXVILLE TN
37916-2307
US

IV. Provider business mailing address

PO BOX 634706
CINCINNATI OH
45263-4706
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-1111
  • Fax:
Mailing address:
  • Phone: 865-292-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD010273
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: