=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821931544
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TENNESSEE BREAST RADIOLOGY SPECIALISTS,PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 DOWELL SPRINGS BLVD STE 200
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37909-2457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-584-0291
-----------------------------------------------------
Fax | 865-584-4425
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2034 PINETREE LN STE 218
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78232-4938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-614-0959
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | DR. MICHAEL J DELEO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 781-729-3189
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------