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NPI Code Detail

MEDICARE: GORDON S GREESON JR. MD

MEDICARE: GORDON S GREESON JR. MD
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 Physician9090TN

General Provider Information

NPI Number : 1346217189
Entity Type Code : Individual
Provider Name (Legal Business Name) : GORDON S GREESON JR. MD
Provider Business Mailing Address
First Line : 600 ARTHUR ST
Second Line :
City : KNOXVILLE
State : TN
Zip : 37921-6405
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-541-6952
Provider Business Practice Location Address
First Line : 600 ARTHUR ST
Second Line :
City : KNOXVILLE
State : TN
Zip : 37921-6405
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-541-6952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 11/19/2010

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