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NPI Code Detail

MEDICARE: FORTRESS CORPORATION

MEDICARE: FORTRESS CORPORATION
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
12085R0202XDiagnostic Radiology PhysicianTN

General Provider Information

NPI Number : 1558338798
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORTRESS CORPORATION
Provider Business Mailing Address
First Line : 210 FORT SANDERS WEST BLVD
Second Line : BLDG 3 SUITE 100
City : KNOXVILLE
State : TN
Zip : 37922-3355
Country : US
Telephone Number : 865-531-5400
Fax Number : 865-531-5043
Provider Business Practice Location Address
First Line : 210 FORT SANDERS WEST BLVD
Second Line : BLDG 3 SUITE 100
City : KNOXVILLE
State : TN
Zip : 37922-3355
Country : US
Telephone Number : 865-531-5400
Fax Number : 865-531-5043
Authorized Official
Title or Position : VICE PRESIDENT-FORTRESS CORP
Name : LESLIE IRWIN
Credential :
Telephone Number : 865-531-5248
Provider Enumeration Date : 03/07/2006
Last Update Date : 07/21/2022

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Directions to “FORTRESS CORPORATION ” Practice Location

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