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General NPI Number Information
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NPI Number | 1053371674
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Entity Type | Individual
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Provider Name | HERMANN PETER VALENTINE CLAUSSEN III MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 990 OAK RIDGE TPKE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6976
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Country | US
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Telephone | 865-481-1162
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Fax | 865-481-1863
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Provider Business Mailing Address
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Address Line | PO BOX 11105
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City | KNOXVILLE
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State | TN
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Zip | 37939-1105
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Country | US
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Telephone | 865-588-2928
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Fax | 865-450-9374
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 29823
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License Number State | TN
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