Healthcare Provider Details

I. General information

NPI: 1629421060
Provider Name (Legal Business Name): KUNAL GADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6473 KINGSTON PIKE STE 6473
KNOXVILLE TN
37919-4832
US

IV. Provider business mailing address

3030 NW EXPRESSWAY STE 1000
OKLAHOMA CITY OK
73112-5468
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-8831
  • Fax: 865-588-8841
Mailing address:
  • Phone: 248-781-8593
  • Fax: 801-618-2497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number67588
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number67588
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: