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Organization

FACULTY INTERNAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL DAWN CHAMBERS (BILLING MANAGER)
(865) 288-1548
Entity
Organization

Contact information

Practice address
4005 FOUNTAIN VALLEY DR, SUITE 305, KNOXVILLE, TN 37918-5327
(865) 925-9020
(865) 377-1042
Mailing address
11440 PARKSIDE DR, SUITE 302, KNOXVILLE, TN 37934-2658
(865) 925-9020
(865) 377-1042

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3723629
TN
Enumeration date
02/01/2007
Last updated
08/22/2020
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