MEDICARE: DIAGNOSTIC HEALTH CENTERS OF TENNESSEE, LLC

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	2085R0202X	Diagnostic Radiology Physician
2	293D00000X	Physiological Laboratory	ODC0000000037	TN

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	:	1689622003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC HEALTH CENTERS OF TENNESSEE, LLC

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR STE 400
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7270
Country	:	US
Telephone Number	:	615-261-2306
Fax Number	:	855-588-3545

Provider Business Practice Location Address
First Line	:	601 HALL OF FAME DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37915-3666
Country	:	US
Telephone Number	:	865-525-7100
Fax Number	:	865-971-4719

Authorized Official
Title or Position	:	CFO/SECRETARY
Name	:	MR. WILLIAM P BAKER
Credential	:	CPA
Telephone Number	:	615-550-6044

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/22/2021

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