Healthcare Provider Details

I. General information

NPI: 1699798884
Provider Name (Legal Business Name): ROBERT K TATUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 PARKSIDE DR STE 100
KNOXVILLE TN
37934-1980
US

IV. Provider business mailing address

10810 PARKSIDE DR STE 100
KNOXVILLE TN
37934-1980
US

V. Phone/Fax

Practice location:
  • Phone: 865-218-6660
  • Fax: 865-218-6661
Mailing address:
  • Phone: 865-218-6660
  • Fax: 865-218-6661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD014732
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: