MEDICARE: DR. WILLIAM MINTEER M.D.

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	207RC0000X	Cardiovascular Disease Physician	19289	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	:	1750371928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MINTEER M.D.

Provider Business Mailing Address
First Line	:	1225 E WEISGARBER RD
Second Line	:	SUITE 190
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2604
Country	:	US
Telephone Number	:	865-602-6700
Fax Number	:	865-602-6801

Provider Business Practice Location Address
First Line	:	900 E OAK HILL AVE
Second Line	:	SUITE 600
City	:	KNOXVILLE
State	:	TN
Zip	:	37917-4522
Country	:	US
Telephone Number	:	865-525-6688
Fax Number	:	865-525-0245

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/18/2011

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