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General NPI Number Information
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NPI Number | 1316914914
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Entity Type | Individual
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Provider Name | ALICE B. VIROSLAV M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 8 CADILLAC DR SUITE 200
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City | BRENTWOOD
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State | TN
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Zip | 37027-5087
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Country | US
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Telephone | 615-376-7370
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Fax |
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Provider Business Mailing Address
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Address Line | 308 N PETERS RD SUITE 225
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City | KNOXVILLE
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State | TN
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Zip | 37922-2356
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Country | US
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Telephone | 865-694-0062
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Fax |
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | H9011
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | H9011
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 45728
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 036.125146
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License Number State | IL
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