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General NPI Number Information
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NPI Number | 1851647036
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Entity Type | Organization
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Legal Business Name | MANISHA AND SANJAY THAKUR, MD, PC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 220 FORT SANDERS WEST BLVD BLDG 2 SUITE 200
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City | KNOXVILLE
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State | TN
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Zip | 37922-3398
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Country | US
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Telephone | 865-288-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 220 FORT SANDERS WEST BLVD BLDG 2 SUITE 200
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City | KNOXVILLE
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State | TN
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Zip | 37922-3398
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Country | US
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Telephone | 865-288-4232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANISHA S THAKUR
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Credential | M.D.
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Telephone | 865-288-4232
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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 | MD0000030337
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License Number State | TN
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