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General NPI Number Information
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NPI Number | 1033226162
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Entity Type | Individual
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Provider Name | GREGORY PANOS MIDIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 1819 W CLINCH AVE STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37916-2435
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Country | US
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Telephone | 865-524-3695
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Fax | 865-602-3528
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Provider Business Mailing Address
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Address Line | PO BOX 52948
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City | KNOXVILLE
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State | TN
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Zip | 37950-2948
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Country | US
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Telephone | 865-306-5675
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Fax | 865-584-7712
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD29355
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | MD29355
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MD29355
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License Number State | TN
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