MEDICARE: JULIUS S VONCLEF III 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
1	207Q00000X	Family Medicine Physician	20697	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080193975	OTHER	TN	RR MEDICARE PIN

Other Identifiers

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

General Provider Information

NPI Number	:	1740226646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIUS S VONCLEF III MD

Provider Business Mailing Address
First Line	:	1225 E WEISGARBER RD
Second Line	:	STE 200
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2604
Country	:	US
Telephone Number	:	865-584-4747
Fax Number	:

Provider Business Practice Location Address
First Line	:	2125 W EMORY RD
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-3704
Country	:	US
Telephone Number	:	865-938-5922
Fax Number	:

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	05/13/2008

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