Provider Demographics
NPI:1104453588
Name:IRWIN, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:IRWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 19TH STREET
Mailing Address - Street 2:SUITE 600, TRUSTEES TOWER
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916
Mailing Address - Country:US
Mailing Address - Phone:865-525-4333
Mailing Address - Fax:
Practice Address - Street 1:501 19TH ST STE 600
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1852
Practice Address - Country:US
Practice Address - Phone:865-525-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6170207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease