MEDICARE: RENAL MEDICAL ASSOCIATES PC

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	174400000X	Specialist

Other Identifiers

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

General Provider Information

NPI Number	:	1598717126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	939 EMERALD AVE
Second Line	:	SUITE 610
City	:	KNOXVILLE
State	:	TN
Zip	:	37917-4502
Country	:	US
Telephone Number	:	865-637-8635
Fax Number	:	865-637-4821

Provider Business Practice Location Address
First Line	:	939 EMERALD AVE
Second Line	:	SUITE 610
City	:	KNOXVILLE
State	:	TN
Zip	:	37917-4502
Country	:	US
Telephone Number	:	865-637-8635
Fax Number	:	865-637-4821

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. JUDY THOMPSON
Credential	:
Telephone Number	:	865-637-8635

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	03/16/2010

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Directions to “RENAL MEDICAL ASSOCIATES PC ” Practice Location

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