Healthcare Provider Details

I. General information

NPI: 1457321648
Provider Name (Legal Business Name): ADOLFO J CUADRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1342 PAPERMILL POINTE WAY
KNOXVILLE TN
37909-1903
US

IV. Provider business mailing address

1326 PAPERMILL POINTE WAY
KNOXVILLE TN
37909-1903
US

V. Phone/Fax

Practice location:
  • Phone: 865-673-5000
  • Fax: 865-588-5711
Mailing address:
  • Phone: 865-219-3506
  • Fax: 865-243-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number14017R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number64716
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: