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Individual

DR. JOHN BRUCE IRWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 E OAK HILL AVE, KNOXVILLE, TN 37917-4522
(865) 545-8000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
009436
TN
207P00000X
Emergency Medicine Physician
AI8782523
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0053596
BLUE CROSS
TN
05
3194238
TN
01
930003973
RAILROAD MEDICARE
TN
Enumeration date
05/24/2006
Last updated
08/09/2010
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