Healthcare Provider Details

I. General information

NPI: 1801908223
Provider Name (Legal Business Name): TIMOTHY J PANELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 ALCOA HWY STE 410
KNOXVILLE TN
37920-1545
US

IV. Provider business mailing address

PO BOX 440509
NASHVILLE TN
37244-0509
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-8780
  • Fax: 865-305-8199
Mailing address:
  • Phone: 865-544-8780
  • Fax: 865-544-8199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number21453
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: