Healthcare Provider Details

I. General information

NPI: 1366487449
Provider Name (Legal Business Name): RONALD J ESTES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 SUTHERLAND AVE SUITE 103
KNOXVILLE TN
37919
US

IV. Provider business mailing address

PO BOX 94670
OKLAHOMA CITY OK
73143-4670
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-8831
  • Fax:
Mailing address:
  • Phone: 405-682-3303
  • Fax: 405-384-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number17091
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number17091
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: