MEDICARE: KAREN S PRILL 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	207R00000X	Internal Medicine Physician	0101055816	VA
2	207RH0003X	Hematology & Oncology Physician	0101055816	VA
3	207RH0003X	Hematology & Oncology Physician	18353-875	WI
4	207R00000X	Internal Medicine Physician	29304	TN
5	207RX0202X	Medical Oncology Physician	29304	TN
6	207RX0202X	Medical Oncology Physician	0101055816	VA
7	207RH0003X	Hematology & Oncology Physician	MD0000029304	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	900000024	OTHER	VA	TRAILBLAZERS MEDICARE
2	900001693	OTHER	VA	PALMETTO RR MEDICARE
4	900001693	OTHER	TN	PALMETTTO RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1902899818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN S PRILL MD

Provider Business Mailing Address
First Line	:	271 MEDICAL PARK BLVD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7455
Country	:	US
Telephone Number	:	423-968-2311
Fax Number	:	423-968-2312

Provider Business Practice Location Address
First Line	:	271 MEDICAL PARK BLVD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7455
Country	:	US
Telephone Number	:	423-968-2311
Fax Number	:	423-968-2312

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	03/20/2025

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Directions to “ KAREN S PRILL MD” Practice Location

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