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General NPI Number Information
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NPI Number | 1225038490
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Entity Type | Individual
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Provider Name | DEVAPIRAN JAISHANKAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 1410 TUSCULUM BLVD STE 2200
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City | GREENEVILLE
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State | TN
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Zip | 37745-5822
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Country | US
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Telephone | 423-639-0243
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Fax | 423-639-0628
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Provider Business Mailing Address
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Address Line | 900 E HILL AVE STE 230
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City | KNOXVILLE
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State | TN
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Zip | 37915-2565
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Country | US
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Telephone | 865-862-0998
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Fax | 865-544-1861
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 45463
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License Number State | TN
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