Healthcare Provider Details

I. General information

NPI: 1689622003
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CENTERS OF TENNESSEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HALL OF FAME DR
KNOXVILLE TN
37915-3666
US

IV. Provider business mailing address

800 CRESCENT CENTRE DR STE 400
FRANKLIN TN
37067-7270
US

V. Phone/Fax

Practice location:
  • Phone: 865-525-7100
  • Fax: 865-971-4719
Mailing address:
  • Phone: 615-261-2306
  • Fax: 855-588-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License NumberODC0000000037
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. WILLIAM P BAKER
Title or Position: CFO/SECRETARY
Credential: CPA
Phone: 615-550-6044