Healthcare Provider Details

I. General information

NPI: 1295908150
Provider Name (Legal Business Name): TROY F. KIMSEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 W CLINCH AVE SUITE 200
KNOXVILLE TN
37916-2434
US

IV. Provider business mailing address

PO BOX 52948
KNOXVILLE TN
37950-2948
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3695
  • Fax: 865-602-3528
Mailing address:
  • Phone: 865-306-5708
  • Fax: 865-584-7712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number51291
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD51291
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: