MEDICARE: RHEUMATOLOGY ASSOCIATES OF ETN

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
1	207RR0500X	Rheumatology Physician	013564	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	091320	OTHER	TN	BLUE CROSS

General Provider Information

NPI Number	:	1568444032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHEUMATOLOGY ASSOCIATES OF ETN

Provider Business Mailing Address
First Line	:	324 N PARK 40 BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3624
Country	:	US
Telephone Number	:	865-691-4100
Fax Number	:	865-691-6178

Provider Business Practice Location Address
First Line	:	324 N PARK 40 BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3624
Country	:	US
Telephone Number	:	865-691-4100
Fax Number	:	865-691-6178

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES L BURNS JR.
Credential	:	MD
Telephone Number	:	865-691-4100

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	08/22/2020

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1235118803 — JAMES L. BURNS JR. MD
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Practice Fax: 865-691-6178

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