Provider Demographics
NPI:1730395104
Name:ENDOCRINOLOGY CONSULTANTS OF EAST TN
Entity type:Organization
Organization Name:ENDOCRINOLOGY CONSULTANTS OF EAST TN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-824-4208
Mailing Address - Street 1:1450 DOWELL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2442
Mailing Address - Country:US
Mailing Address - Phone:865-617-8661
Mailing Address - Fax:865-588-3383
Practice Address - Street 1:1450 DOWELL SPRINGS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2444
Practice Address - Country:US
Practice Address - Phone:865-637-8812
Practice Address - Fax:865-588-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH78755Medicare UPIN
TNF54563Medicare UPIN
TNF71485Medicare UPIN
TNA98884Medicare UPIN
TNG94379Medicare UPIN
TND73325Medicare UPIN
TNE57947Medicare UPIN
TNC46901Medicare UPIN