Healthcare Provider Details

I. General information

NPI: 1598717126
Provider Name (Legal Business Name): RENAL MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7650 DANNAHER DR STE 200
POWELL TN
37849-4066
US

IV. Provider business mailing address

7650 DANNAHER DR STE 200
POWELL TN
37849-4066
US

V. Phone/Fax

Practice location:
  • Phone: 865-637-8635
  • Fax: 865-637-4821
Mailing address:
  • Phone: 865-637-8635
  • Fax: 865-637-4821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CRYSTAL BAILEY
Title or Position: BILLING MANAGER
Credential:
Phone: 865-637-8635