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General NPI Number Information
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NPI Number | 1558338798
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Entity Type | Organization
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Legal Business Name | FORTRESS CORPORATION
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 210 FORT SANDERS WEST BLVD BLDG 3 SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37922-3355
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Country | US
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Telephone | 865-531-5400
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Fax | 865-531-5043
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Provider Business Mailing Address
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Address Line | 210 FORT SANDERS WEST BLVD BLDG 3 SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37922-3355
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Country | US
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Telephone | 865-531-5400
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Fax | 865-531-5043
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Authorized Official
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Title or Position | VICE PRESIDENT-FORTRESS CORP
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Name | LESLIE IRWIN
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Credential |
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Telephone | 865-531-5248
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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 |
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License Number State | TN
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