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Individual

KEN MARK TASHIRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 BETHEL VALLEY RD BLDG 4500N, MS 6220, OAK RIDGE, TN 37830-8050
(865) 574-7431
Mailing address
PO BOX 2008, 4500N MS 6220, OAK RIDGE, TN 37831-2008
(865) 574-7431

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036188A
IN
207Q00000X
Family Medicine Physician
60631
TN
2083A0100X
Aerospace Medicine Physician
01036188A
IN
2083A0100X
Aerospace Medicine Physician
60631
TN
2083X0100X
Occupational Medicine Physician
Primary
60631
TN

Other

Enumeration date
01/09/2007
Last updated
02/05/2026
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