Healthcare Provider Details

I. General information

NPI: 1841619376
Provider Name (Legal Business Name): NEPHROLOGY SERVICES OF EAST TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2014
Last Update Date: 04/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 CREST RD SUITE B
MARYVILLE TN
37804-4304
US

IV. Provider business mailing address

1633 CHURCH ST
NASHVILLE TN
37203-2990
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-2212
  • Fax: 865-983-0905
Mailing address:
  • Phone: 615-327-3061
  • Fax: 615-329-2513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES E ATTRILL JR.
Title or Position: PRESIDENT
Credential:
Phone: 615-327-3061