Healthcare Provider Details

I. General information

NPI: 1700970605
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY OF KNOXVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 E WEISGARBER RD STE A
KNOXVILLE TN
37909
US

IV. Provider business mailing address

1114 E WEISGARBER RD STE A
KNOXVILLE TN
37909
US

V. Phone/Fax

Practice location:
  • Phone: 865-558-8839
  • Fax: 865-588-3781
Mailing address:
  • Phone: 865-558-8839
  • Fax: 865-588-3781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD4561
License Number StateTN

VIII. Authorized Official

Name: MR. ALDRIDGE TROUTMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 865-558-5898