=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699199562
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERX HOSPITALIST GROUP PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2014
-----------------------------------------------------
Last Update Date | 01/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9724 KINGSTON PIKE SUITE 406
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37922-3347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-777-1300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9724 KINGSTON PIKE STE 208
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37922-3389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-777-1300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ROBERT DEVRNJA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 865-777-1300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------