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NPI Code Detail

MEDICARE: DR. ARUN JETHANANDANI M.D.

MEDICARE: DR. ARUN JETHANANDANI M.D.
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
12084P0800XPsychiatry Physician19675TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255300356
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ARUN JETHANANDANI M.D.
Provider Business Mailing Address
First Line : 2455 SUTHERLAND AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-2355
Country : US
Telephone Number : 865-523-8695
Fax Number : 865-523-6827
Provider Business Practice Location Address
First Line : 5310 BALL CAMP PIKE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37921-3234
Country : US
Telephone Number : 865-523-4704
Fax Number : 865-602-2387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 09/12/2018

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