# TENNESSEE INNOVATIVE MEDICAL SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114285400
- **Authorized official:** JASON G. FUNDERBURK MD (SOLE OWNER)
- **Authorized official phone:** (865) 777-6880

## Contact information

- **Practice address:** 116 CONCORD RD, STE 400, KNOXVILLE, TN 37934-2940
- **Practice address phone:** (865) 777-6880
- **Practice address fax:** (865) 777-6881
- **Mailing address:** 194 MARKET PLACE BLVD, KNOXVILLE, TN 37922-2337
- **Mailing address phone:** (865) 560-8787
- **Mailing address fax:** (865) 560-8784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | TN | Yes |

## Other

- **Enumeration date:** 04/25/2012
- **Last updated:** 07/02/2012