Healthcare Provider Details

I. General information

NPI: 1790785749
Provider Name (Legal Business Name): WILLIAM S MUSE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 LAUREL AVE SUITE 502
KNOXVILLE TN
37916-1810
US

IV. Provider business mailing address

9724 KINGSTON PIKE SUITE 800
KNOXVILLE TN
37922-3347
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-6005
  • Fax: 865-546-5678
Mailing address:
  • Phone: 865-690-0602
  • Fax: 865-690-0515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD0000006000
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: