Healthcare Provider Details

I. General information

NPI: 1679609473
Provider Name (Legal Business Name): NEOHEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 OAK RIDGE TPKE
OAK RIDGE TN
37830-6976
US

IV. Provider business mailing address

440 WYNDHAM HALL LN
KNOXVILLE TN
37934-2655
US

V. Phone/Fax

Practice location:
  • Phone: 865-742-5718
  • Fax:
Mailing address:
  • Phone: 865-742-5718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY K. BROWN
Title or Position: PRESIDENT
Credential: MD
Phone: 865-742-5718