Healthcare Provider Details
I. General information
NPI: 1902022874
Provider Name (Legal Business Name): KNOXVILLE INTERNAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 E BLOUNT AVE SUITE 740
KNOXVILLE TN
37920-1632
US
IV. Provider business mailing address
101 E BLOUNT AVE SUITE 740
KNOXVILLE TN
37920-1601
US
V. Phone/Fax
- Phone: 865-632-5885
- Fax: 865-632-5893
- Phone: 865-632-5885
- Fax: 865-632-5893
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
CHAIN
Title or Position: PRACTICE ADM
Credential:
Phone: 865-632-5885