Provider Demographics
NPI:1700165081
Name:SVENDSEN, TORBEN (DO)
Entity type:Individual
Prefix:DR
First Name:TORBEN
Middle Name:
Last Name:SVENDSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:TORBEN
Other - Middle Name:
Other - Last Name:SVENDSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:7794 RHEA COUNTY HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5981
Mailing Address - Country:US
Mailing Address - Phone:423-285-6240
Mailing Address - Fax:423-443-4070
Practice Address - Street 1:195 WHITE OAK ROAD
Practice Address - Street 2:STE 100
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5981
Practice Address - Country:US
Practice Address - Phone:423-285-6240
Practice Address - Fax:877-276-2910
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3115207Q00000X
TN2621208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ038105Medicaid