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NPI Code Detail

MEDICARE: STEVEN R MYNATT MD

MEDICARE:   STEVEN R MYNATT  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
1175T00000XPeer Specialist
2208800000XUrology Physician12896TN

General Provider Information

NPI Number : 1619976156
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN R MYNATT MD
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 526 LAMAR ST
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-7343
Country : US
Telephone Number : 865-541-6635
Fax Number : 865-541-6942
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 04/11/2024

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Directions to “ STEVEN R MYNATT MD” Practice Location

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