MEDICARE: HIGH RISK OBSTETRICAL CONSULTANTS, PLLC

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	207VM0101X	Maternal & Fetal Medicine Physician		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	:	1770724676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH RISK OBSTETRICAL CONSULTANTS, PLLC

Provider Business Mailing Address
First Line	:	1930 ALCOA HWY STE A435
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1520
Country	:	US
Telephone Number	:	865-263-2400
Fax Number	:	865-263-2441

Provider Business Practice Location Address
First Line	:	1930 ALCOA HWY STE A435
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1520
Country	:	US
Telephone Number	:	865-263-2400
Fax Number	:	865-263-2441

Authorized Official
Title or Position	:	OWNER
Name	:	MARK D HENNESSY
Credential	:	MD
Telephone Number	:	865-263-2400

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	12/15/2022

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Directions to “HIGH RISK OBSTETRICAL CONSULTANTS, PLLC ” Practice Location

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