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General NPI Number Information
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NPI Number | 1336115419
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Entity Type | Individual
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Provider Name | THOMAS J EBERTS MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 137 BLOUNT AVE
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City | KNOXVILLE
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State | TN
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Zip | 37871
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Country | US
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Telephone | 865-632-5992
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Fax | 865-632-5316
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Provider Business Mailing Address
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Address Line | PO BOX 11784
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City | KNOXVILLE
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State | TN
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Zip | 37939-1784
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 21500
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License Number State | TN
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