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Organization
TENNESSEE INNOVATIVE MEDICAL SERVICES PLLC
Active
Organization
TENNESSEE INNOVATIVE MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON G. FUNDERBURK MD (SOLE OWNER)
(865) 777-6880
Entity
Organization
Contact information
Practice address
116 CONCORD RD, STE 400, KNOXVILLE, TN 37934-2940
(865) 777-6880
(865) 777-6881
Mailing address
194 MARKET PLACE BLVD, KNOXVILLE, TN 37922-2337
(865) 560-8787
(865) 560-8784
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
TN
Other
Enumeration date
04/25/2012
Last updated
07/02/2012
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