Healthcare Provider Details

I. General information

NPI: 1578727038
Provider Name (Legal Business Name): IOANNIS PARASTATIDIS M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 MEDICAL PARK DR STE 301
LENOIR CITY TN
37772-5798
US

IV. Provider business mailing address

689 MEDICAL PARK DR STE 301
LENOIR CITY TN
37772-5798
US

V. Phone/Fax

Practice location:
  • Phone: 865-988-9970
  • Fax: 865-271-6621
Mailing address:
  • Phone: 865-988-9970
  • Fax: 865-271-6621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number76597
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number067025
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: