Healthcare Provider Details

I. General information

NPI: 1770652372
Provider Name (Legal Business Name): REGIONAL NEONATAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

IV. Provider business mailing address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9749
  • Fax: 865-305-5857
Mailing address:
  • Phone: 865-305-9749
  • Fax: 865-305-5857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALISA PORTER
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 865-305-9749