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General NPI Number Information
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NPI Number | 1619947876
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Entity Type | Individual
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Provider Name | DANIEL M IBACH MD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 9957 SHERRILL BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37932-3366
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Country | US
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Telephone | 865-693-2255
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Fax | 865-691-7888
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Provider Business Mailing Address
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Address Line | PO BOX 10988
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City | KNOXVILLE
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State | TN
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Zip | 37939-0988
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 29724
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License Number State | TN
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