MEDICARE: CARL A RASMUSSEN PAC

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	363A00000X	Physician Assistant	PA0000000071	TN

General Provider Information

NPI Number	:	1629009410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL A RASMUSSEN PAC

Provider Business Mailing Address
First Line	:	1400 DOWELL SPRINGS BLVD
Second Line	:	SUITE 200
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2456
Country	:	US
Telephone Number	:	865-584-0291
Fax Number	:	865-584-4426

Provider Business Practice Location Address
First Line	:	1400 DOWELL SPRINGS BLVD
Second Line	:	SUITE 200
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2456
Country	:	US
Telephone Number	:	865-584-0291
Fax Number	:	865-584-4426

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	02/19/2010

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Practice Location Address:

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1679505382 — DR. CARYN CORNELIA WUNDERLICH MD
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1790708030 — KAMILIA F KOZLOWSKI
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1245319185 — MR. TIMOTHY DEAN DOUGLASS P.T.
Practice Location Address:

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1518027846 — DR. MARGARET ROSALEE TROXELL D.O.
Practice Location Address:

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1891926440 — RYAN ALEXANDER UNGER MD
Practice Location Address:

1400 DOWELL SPRINGS BLVD , BUILDING 1400, SUITE 340
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Directions to “ CARL A RASMUSSEN PAC” Practice Location

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