Healthcare Provider Details

I. General information

NPI: 1770724676
Provider Name (Legal Business Name): HIGH RISK OBSTETRICAL CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY STE A435
KNOXVILLE TN
37920-1520
US

IV. Provider business mailing address

1930 ALCOA HWY STE A435
KNOXVILLE TN
37920-1520
US

V. Phone/Fax

Practice location:
  • Phone: 865-263-2400
  • Fax: 865-263-2441
Mailing address:
  • Phone: 865-263-2400
  • Fax: 865-263-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number StateTN

VIII. Authorized Official

Name: MARK D HENNESSY
Title or Position: OWNER
Credential: MD
Phone: 865-263-2400