Healthcare Provider Details

I. General information

NPI: 1861795106
Provider Name (Legal Business Name): KNOX COUNTY HEALTH DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 12/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAMERON AVE
KNOXVILLE TN
37917-6413
US

IV. Provider business mailing address

140 DAMERON AVE PED. DEPT.
KNOXVILLE TN
37917-6413
US

V. Phone/Fax

Practice location:
  • Phone: 865-215-5437
  • Fax:
Mailing address:
  • Phone: 865-215-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License NumberLPN0000038059
License Number StateTN

VIII. Authorized Official

Name: DR. MARTHA L BUCHANAN
Title or Position: HEALTH DEPT. DIRECTOR
Credential: MD
Phone: 865-215-5300