Healthcare Provider Details

I. General information

NPI: 1891745436
Provider Name (Legal Business Name): RODNEY STURGEON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4117 E EMORY RD
KNOXVILLE TN
37938-4229
US

IV. Provider business mailing address

1275 DICK LONAS RD
KNOXVILLE TN
37909-1326
US

V. Phone/Fax

Practice location:
  • Phone: 865-922-2121
  • Fax: 865-922-0006
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-584-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number43064
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: