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General NPI Number Information
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NPI Number | 1417769779
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Entity Type | Organization
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Legal Business Name | KNOX PRIMARY CARE LLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 9314 PARK WEST BLVD STE 404
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City | KNOXVILLE
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State | TN
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Zip | 37923-4329
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Country | US
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Telephone | 865-234-2347
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Fax |
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Provider Business Mailing Address
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Address Line | 12278 FREDERICKSBURG BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-6667
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Country | US
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Telephone | 865-406-0677
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Fax | 865-347-3975
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Authorized Official
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Title or Position | MEMBER
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Name | AMISH PATEL
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Credential |
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Telephone | 865-406-0677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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