Healthcare Provider Details

I. General information

NPI: 1962604140
Provider Name (Legal Business Name): ARSENIY V. TSAPENKO M.D., D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 ALCOA HWY SUITE E210
KNOXVILLE TN
37920-2244
US

IV. Provider business mailing address

1940 ALCOA HWY SUITE E210
KNOXVILLE TN
37920-2244
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-7471
  • Fax: 865-305-6563
Mailing address:
  • Phone: 865-524-7471
  • Fax: 865-305-6563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2304
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number2304
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: