Healthcare Provider Details

I. General information

NPI: 1679502314
Provider Name (Legal Business Name): MEI-FUNG KERLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 HIGHLAND AVE
KNOXVILLE TN
37916-1217
US

IV. Provider business mailing address

2001 HIGHLAND AVE
KNOXVILLE TN
37916-1217
US

V. Phone/Fax

Practice location:
  • Phone: 865-633-0353
  • Fax: 865-633-0353
Mailing address:
  • Phone: 865-633-0353
  • Fax: 423-979-3483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number24685
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24685
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: