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NPI Code Detail

MEDICARE: DR. HERMAN G BOTERO D.O.

MEDICARE: DR. HERMAN G BOTERO D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician2089TN
2207XS0114XAdult Reconstructive Orthopaedic Surgery Physician2089TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01361606OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26016883OTHERTNBLUECROSS BLUESHIELD
49292410OTHERTNAETNA

General Provider Information

NPI Number : 1023094349
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERMAN G BOTERO D.O.
Provider Business Mailing Address
First Line : 8320 E WALKER SPRINGS LN STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3120
Country : US
Telephone Number : 865-769-4500
Fax Number : 865-769-4501
Provider Business Practice Location Address
First Line : 1422 OLD WEISGARBER RD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1293
Country : US
Telephone Number : 865-558-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 01/14/2026

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