Healthcare Provider Details

I. General information

NPI: 1174676688
Provider Name (Legal Business Name): JOANNE MARIE CLINCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. JOANNE MARIE CARELLA

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/22/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 VOLUNTEER BLVD
KNOXVILLE TN
37996-7386
US

IV. Provider business mailing address

1800 VOLUNTEER BLVD
KNOXVILLE TN
37996-4522
US

V. Phone/Fax

Practice location:
  • Phone: 865-974-3135
  • Fax: 865-974-2000
Mailing address:
  • Phone: 865-974-3135
  • Fax: 865-974-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0000067647
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: