Healthcare Provider Details

I. General information

NPI: 1568644193
Provider Name (Legal Business Name): TENNESSEE ORTHOPAEDIC CLINICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 PARK WEST BLVD SUITE 235
KNOXVILLE TN
37923-4200
US

IV. Provider business mailing address

PO BOX 32569
KNOXVILLE TN
37930-2569
US

V. Phone/Fax

Practice location:
  • Phone: 865-560-8560
  • Fax: 865-560-8561
Mailing address:
  • Phone: 865-694-0062
  • Fax: 865-694-7907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZENA ANN MCCONNELL
Title or Position: CREDENTIALING
Credential: CPC, CPCO
Phone: 865-694-0062