Healthcare Provider Details

I. General information

NPI: 1982666442
Provider Name (Legal Business Name): DANIEL F. ALDERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 11/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 SUTHERLAND AVE STE 107
KNOXVILLE TN
37919-2333
US

IV. Provider business mailing address

PO BOX 11167
KNOXVILLE TN
37939-1167
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-8631
  • Fax: 406-587-1343
Mailing address:
  • Phone: 865-584-7376
  • Fax: 865-540-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9771
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number9771
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: