Healthcare Provider Details

I. General information

NPI: 1417265414
Provider Name (Legal Business Name): JOSEPH BENJAMIN FIKES PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 CENTERPOINT BLVD SUITE 100
KNOXVILLE TN
37932-1984
US

IV. Provider business mailing address

2535 CUSHING AVE
MURFREESBORO TN
37130-6669
US

V. Phone/Fax

Practice location:
  • Phone: 865-539-8000
  • Fax:
Mailing address:
  • Phone: 615-736-4738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: