Healthcare Provider Details

I. General information

NPI: 1538148630
Provider Name (Legal Business Name): NORBERT E. BAUMGARTNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9125 CROSS PARK DR STE 200
KNOXVILLE TN
37923-4563
US

IV. Provider business mailing address

9125 CROSS PARK DR STE 200
KNOXVILLE TN
37923-4563
US

V. Phone/Fax

Practice location:
  • Phone: 865-632-5900
  • Fax: 865-374-2129
Mailing address:
  • Phone: 865-632-5900
  • Fax: 865-374-2129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number4301067811
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number59694
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: