Healthcare Provider Details

I. General information

NPI: 1740225002
Provider Name (Legal Business Name): LINDA R. HOERSTEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 W CLINCH AVE
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

3433 RUSSELLWOOD DR
ROCKFORD TN
37853-3923
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12301
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: